Shanti had been taken from her job in Nepal and forced into sex trafficking in India as a teenager. After escaping and returning home, Shanti’s family and community rejected her upon learning she was living with HIV, and she was forced to find work and housing on her own. For a time, she was so unwell that she had to leave her daughter, Kranti, at an orphanage. 

Then, in 2015, a 7.8-magnitude earthquake hit Nepal, and a border blockade between Nepal and India, cut off the supply of critical medications into Nepal, including the HIV treatment on which Shanti’s life depended. 

“She contacted all her friends, she had to help her find the medicine or to get me adopted because I had no one besides her,” Kranti said. 

Despite her personal desperation, Shanti threw herself into the post-earthquake relief efforts. “With no hope of survival, I resolved that even if this was my destined death, I would want to die working for my community,” she said.

The Start of a Movement

With the help of a friend, Shanti connected with Direct Relief, which provided a supply of antiretroviral drugs for a number of Nepali people living with HIV, including Shanti.

“We love to say that Direct Relief saved my mother’s life,” Kranti shared. “And when she felt that she had been given a second chance to her life, she had to do more for her community.”

In 2016, Shanti and six other women founded the Shanti Foundation, a year after the devastating earthquake. The organization quickly got to work educating the Nepali public and government officials about trafficking, HIV, and sexual and gender-based violence. Their team also helps rescue, rehabilitate, and reintegrate trafficking survivors and people living with HIV. Even though she was still a teenager, Shanti’s daughter, Kranti, played a critical role for the new organization as she knew English and could help translate from Nepalese for people who were willing to support their movement.

And given the story behind her name, Kranti is a true embodiment of this movement. The doctor who delivered her called her “Kranti,” which means “revolution” in Nepalese because she was the first baby in Nepal to receive antiretroviral therapy treatment, which prevents a mother with HIV from transmitting the disease to her newborn. 

In Nepal, HIV is still highly stigmatized. It is not uncommon for children whose parents live with HIV to be kicked out of school, and for children to abandon their parents when they learn that they learn about their parents’ condition. Kranti shared that not having HIV prevented her from experiencing much of the fear and isolation faced by her friends who are living with HIV.

“It was very hard for my friends with HIV every time they would have to take the medication during the school day. Everyone would come and ask them, ‘What are you taking medication for?’ And, of course, they will not tell it’s about HIV, but they’ll always have this fear that they’d be found out.  And one time, my friend’s mother began talking about her story and joining the [anti-trafficking, anti-HIV stigma] movement. And her friends found out, and she was just isolated.”

A Dream Come True

The persistent stigma and lack of resources for those living with HIV led Shanti and Kranti to the dream of having a community house in Nepal’s capital, Kathmandu. 

All advanced healthcare services for people living with HIV are based in Kathmandu, and even if one is lucky enough to know someone in the city, housing is often refused during treatment because of the stigma around HIV. Many are coming from poorer, rural areas of the country and can’t afford a hotel or other accommodations while they seek treatment.

With funding from Direct Relief in 2021, the Shanti Foundation was able to buy a two-story building to provide housing and community for these people left with nowhere else to go. It features two rooftops – one features a communal kitchen, where residents take turns cooking meals, and the other provides space for a garden that produces fresh vegetables for the community. Handicraft classes also teach women skills to make and sell bracelets, necklaces and other items. “They have made [the center] very beautiful,” Kranti said.

Since the home’s opening, over 70 people living with HIV have lived at the house. Some stay for a few days, and others – often elderly or those living with advanced stages of the disease – anticipate living the rest of their lives at the center.  The center also accommodates sex trafficking survivors.

Challenges and Opportunities Ahead 

Eight years after the Shanti Foundation’s beginning, Kranti is now 21 years old, in her final year of university, and is a volunteer at the Kathmandu center as well as a volunteer development officer for the Shanti Foundation. 

The challenges and opportunities ahead of the foundation are especially clear to her now as she recently returned home from her first trip outside Nepal. After being nominated by staff at the American embassy in Kathmandu, she flew to the U.S. for a three-week leadership program sponsored by the U.S. Department of State, where groups from 22 different countries came together to learn and share about anti-trafficking efforts in their own countries and in the U.S. 

“We went to the Department of Labor, Department of Transportation, Department of Justice; everyone had their own task force for anti-human trafficking,” Kranti shared. “Each law enforcement has victim advocates, investigators, and prosecutors dedicated and trained to these programs.”

In contrast, “trafficking is regarded as just a ‘woman thing’ in our country,” she said. 

“And it is only operated by the Ministry of Women, which is always falling short on resources and things that they want to really do. And we are pressing on the Ministry of Women, because that is also that is only the institution that is really internalizing this issue. But I think we might have to embrace the challenge and go with other ministries like transportation, labor, etc., that have a big role to play in order to prevent this crime.”

Also, Kranti learned from other members of the leadership program that over 50 Nepalese women were being rescued from trafficking in Greece, and other Nepalese people had just been rescued in Cyprus.

“When they have to be repatriated back to the country, they do need support, and we’re in the country to provide that,” said Kranti. “Before now, we knew our people were there, but we didn’t know whom to contact. Now we know whom we can contact, and we can help each other.”

For Kranti, this trip was “most importantly about spreading the words of my mother around the [U.S.] and beyond.”

“Through [Direct Relief’s] support, one Shanti was saved, but the impact goes far beyond, now supporting the lives of countless others.”

The shipments contained 8.2 million defined daily doses of medication and supplies, including antibiotics, personal protection equipment, personal care kits and more.

Supporting Migrants from Haiti in Mexico

This week, in collaboration with Hospitalidad y Solidaridad and the International Organization for Migration, over 500 Direct Relief personal care kits were distributed to migrants in Tapachula, Chiapas, Mexico. This initiative aims to provide vital support amid the tumultuous circumstances faced by thousands awaiting asylum processing in Tapachula.

Why It Matters:

The crisis unfolding in Tapachula underscores the urgent need for humanitarian assistance and the importance of solidarity and support for vulnerable populations. As the primary destination for many migrants fleeing violence and instability in neighboring countries, Mexico faces the challenge of providing aid and protection to those seeking refuge within its borders.

Direct Relief’s Response:

This event provides essential personal care kits, filled with hygiene items including toothpaste and shampoo, to alleviate the immediate needs of migrants, particularly from Haiti, residing in Tapachula. These kits will not only contribute to improved health and sanitation but also offer support to individuals navigating challenging circumstances.

Key Insights:

• The situation in Tapachula is indicative of broader migration trends, with Haiti surpassing Honduras as the leading source of asylum seekers in Mexico.
• Discrimination and systemic challenges persist in the asylum process, particularly for Haitian migrants who often face barriers to recognition and support.
• The testimonies of migrants highlight the dire conditions and systemic injustices driving their journeys, emphasizing the need for comprehensive solutions and international cooperation.

Strengthening Health Services in Culebra

As part of Direct Relief’s efforts to breach healthcare access gaps for vulnerable populations in Puerto Rico, Direct Relief staff, alongside medical staff from HealthProMed and La Fondita de Jesús, conducted a community health fair in the island municipality of Culebra on Friday, March 15. The team distributed personal care kits filled with hygiene items, solar-powered lights, and groceries to 100 people.

Historically, residents in Culebra have been isolated both physically and in terms of resources, including food, health services and transportation, among others. Located east of the main island, Culebra commonly experiences the impacts of hurricanes prior to their landfall in mainland Puerto Rico.

Health staff from La Fondita de Jesús evaluated more than 26 patients from their Direct Relief-donated mobile unit. The team also offered training on stress and anxiety management, proper use of medication, counseling on substance abuse and community development to more than 100 participants.

HealthProMed, a federally qualified health center in the area, offered blood pressure, glucose and HIV tests, health education and nutrition training to 96 registered patients. This community health fair further stressed the need to mobilize healthcare services to vulnerable and isolated communities. Many of the patients that were seen rely on maritime transportation to the main island to receive basic medical services.

At the island’s local public school, located adjacent to the health fair’s location, HealthProMed simultaneously held nutritional talks for over 60 students from elementary and middle school to promote increased physical activity, highlighting the importance of sports. Additionally, they hosted a basketball exhibition game for the students. Fundación Atención Atención also provided their Play-Time hour to foster emotion management and resilience through play for 35 children.

Bungie Bounty for Good

The Bungie Foundation, which has supported Direct Relief with several fundraising campaigns in the past, ran a four-hour live broadcast on Friday, May 22. The event showcased Bungie’s feature game, Destiny 2, and raised awareness of Direct Relief’s work. The Bungie Foundation has partnered with Direct Relief since 2015, beginning after the devastating earthquake in Nepal when the Bungie community rallied together to raise more than $1 million for the response efforts. Learn more about streaming and Direct Relief here.

Operational Snapshot

WORLDWIDE

Over the last week, Direct Relief shipped more than 6.7 million defined daily doses of medication outside the U.S.

Thirty pallets of requested medical supplies and medications departed Direct Relief’s warehouse in Santa Barbara, California, on March 19, 2024, bound for Ukraine. The shipment will be received by Ukrainian Soul and distributed to local healthcare facilities.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 497 shipments containing over four tons of medications during the past seven days to organizations, including the following:

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 5,383 shipments to 1,324 partner organizations in 53 U.S. states and territories and 57 countries.

These shipments contained 85.2 million defined daily doses of medication totaling 1.5 million lbs.

In the News

Critical hospital supplies and insulin for children with diabetes are among requested shipments making their way through treacherous shipping routes – Angels in Medicine

AmeriCorps hosting homeless outreach in Isla Vista – KEYT

MEXICO CITY — As the traffic light turns red, and cars come to a halt, the driver of a truck makes a swift gesture to Wilyender, 15, and Mervin, 17, who rush towards the vehicle to clean the windshield. Both have perfectly cut hair that contrasts with their heavily worn shoes.

After approaching the driver and cleaning the windshield with serious, focused looks, the teens display big smiles while splitting the couple of coins the driver gave them. In the lane next to them, Alexandra, 10, has less luck.

“God bless you anyway, don’t worry, maybe for the next time,” Alexandra says in a notably polite and gentle voice, smiling as she moves towards the next vehicle.  

In another lane, Yordi Romero, 34, sells lollipops. He offers the candy to drivers with one hand while using his other hand to push a wheelchair carrying Nerli, 16, who is the daughter of Yordi’s partner, Kelly. Nerli has spina bifida.

The light turns green, but for these migrants, life remains on hold.

Finding Shelter

A few meters from this bustling intersection lies the Northern Bus Terminal of Mexico City, a transportation hub for the northern regions of Mexico and the U.S. border. In recent months it has become an important stop for migrants on their journey to the United States. Different nationalities, different needs and dreams converge at this point, all hoping to continue their migratory journey as quickly and safely as possible. But it is not easy for everyone to move forward.

In a parking lot nearby, there is an improvised migrant camp housing about 50 families in tents and makeshift houses constructed from found materials — and a lot of ingenuity. It is surrounded by big avenues and metro tracks, though still very much out in the open. 

From these flimsy dwellings, most migrants repeatedly attempt to secure a coveted appointment with U.S. Customs and Border Protection (CBP) through CBP One, a digital application. The app has been used by migrants to make more than 64 million requests to enter the U.S. Overloaded with this high number of users, many users report the app is often slow and unstable. With each crash, the number of requests increases, as does the number of migrants stuck in limbo in Mexico City. 

For two months, Yordi Romero, his partner, Kelly Leal, and their 4 children slept in the tents near the terminal. There were no available restrooms, much less any resources to address Nerli’s specific needs due to spina bifida. They managed to rent space in a mechanic’s workshop converted into a room for rent. Yordi has worked various jobs since arriving in Mexico, including at a nearby construction site on 10-hour shifts to pay for lodging and some food. 

The family, from Maracaibo, Venezuela, also battled the CBP One app, spending many long nights trying to cajole the app to work, while longing to continue their journey north.

The Beast or The Wait

The complex and slow immigration process pushes many individuals, and even whole families, to face the difficult decision of waiting for the luck of an appointment in rough conditions or continuing along riskier routes like the infamous “La Bestia” train. This generic term refers to a vast network of freight trains in Mexico known for multiple accidents and deaths.  

But the danger is not only accidental; armed groups linked to drug cartels often target the train and the surrounding areas it passes to rob, extort, and kidnap migrants. Police abuse and corruption by various law enforcement agencies are also a threat to migrants. 

A few months ago, during a previous visit to the train, a young Venezuelan migrant who introduced himself just as “Oriente” explained that “La Bestia” is not the train itself, but rather the migrants capable of enduring and overcoming so many obstacles and risks.  

“The real beasts are us that can ride it,” he shouted as he jumped from one wagon to another, seeking a better “seat” for the ride.

In a lonely remote area on the outskirts of Mexico City, a young couple from Venezuela said they preferred to try to reach the border by train as soon as possible rather than sleep in the street with their three kids. On the side of the tracks, their daughter Fabiana, 6, was distracted by the lights generated by her shoes with each step she took among rocks, debris, rails, cacti, and other elements that make up the beautiful, yet hostile landscape along the train route. 

Breaking the stillness, a train arrives, and about 20 people run in all directions, trying to find a spot that gives some sense of safety. Not everyone finds it. The following day, via text message, Fabiana’s father said he was separated from his wife and one of his kids. His wife was without currency, a phone, or food. The next train would not stop within walking distance of her location, and traveling with their child, she couldn’t jump on it.

He later found out that his wife and child were detained by Mexican migration police and sent to an unknown town where they had to find shelter, money and a way to get in touch with him. It would take the family over a month to be reunited closer to the border, despite only being a few hours apart. 

Clinics and Churches Fill Gaps

Sociopolitical instability in different Latin American countries and factors such as violence, repression, and climate change continue to force the displacement of thousands of people. Places like Ecuador, Nicaragua, and Haiti are enduring severe civil unrest, which also has an evident impact in increasing the complexity of migration. 

The Mexican government reported almost 700,000 migrants passed through the country from January through November last year. CBP reported 2.5 million encounters with migrants at the U.S.-Mexico border last year. As the biggest city along the migration route to the U.S., Mexico City, the most populous metropolitan area in North America, is a popular waypoint along the journey to the U.S.

Places like La Soledad Plaza in the city center, bordered by Our Lady of the Solitude church, have become increasingly long-term migrant camps. This complex is one of the city’s largest such camps, with about 3,000 people staying in a shelter next to, and run by, the church and outside on the plaza one night last November. Our Lady of the Solitude, led by Father Benito Torres, and his close collaborator, Claudia Torres, works to alleviate the various difficulties faced by hundreds of migrants.  

“Honestly, I’m not sure what I would have done without the help from this place,” Hugo Saavedra said. “I arrived in Mexico City very sick and fainted yesterday. I couldn’t even stand up, but here they have helped me with medicines, attention and a bed,” Saavedra, who came from Venezuela, said. 

Lack of clean water, public bathrooms, hygiene items, and many other necessities receive significant attention at the church’s shelter, which is coordinated by Claudia, though she gave credit to Father Benito for tirelessly sourcing needed supplies from wherever possible. She said that bed and board are provided to newcomers for three to four days. Healthcare clinics are organized continuously with the local Luis E. Ruiz Health Center.  

During these events, patients are given a complete meal and general check-up. Basic treatments are provided for mild and moderate cases; the most common conditions are respiratory and intestinal infections.  

According to Dr. Marco Antonio Rojas, leader of the medical brigade, one of the biggest challenges in treating migrant patients is their transience, which makes it difficult to monitor their health status. However, Dr. Rojas says consistent and free support is attempted from the shelter. If needed, patients are referred to the hospital network in the area, where they receive specialized care in much-requested areas such as gynecology and pneumology (respiratory system-related care).  

“The challenge often lies in the availability of medications, especially pediatric medicines and antibiotics, for the treatment of respiratory infections. We don’t have a constant supply,” Dr. Rojas said.  

Unable to predict when they will obtain their CBP One appointment, migrants in Mexico City often try to stabilize their situation by working and finding a place to rent. In Iztapalapa, Mexico City’s most populous district, even before the latest surge in migrants, Luis Gerardo Rodríguez has been waiting for confirmation of the process for over three months. He now spends his days working at a fruit and vegetable stand in a market near the shelter. He earns about US$25 a day, working up to 14 hours. It’s enough to help his mother in Venezuela and save some cash for a potential flight to the border once an appointment comes through. 

Exultation, and Next Steps

For some, the appointment finally comes. Yordi Romero and his family cry tears of joy and celebrate after learning they were approved to present themselves to the United States immigration authorities.

Kelly removes sheets from the walls of the converted car mechanic room and discovers a sign that reads “engine repairs.” Rosbelly, 8, combs her hair and ties it with a ribbon. Nerli already has her hair braided and organizes her deck of cards in a shiny gold purse with a smiley face. Yordi puts perfume on Keiner, 6, who was dressed in his Sunday best.

The family heads to the Northern Bus Terminal. Other migrants bid them farewell from their tents. Many of the well-wishers have faced similar ordeals and continue to wait for an appointment. They wave their hands, sending greetings and blessings to Yordi, Kelly, and the kids while harboring hope that they will be the next ones to continue their journey.

Direct Relief has supported medical facilities across Mexico, including regions through which many migrants travel, as well as the health system in Mexico City.

Read More

HUMANITARIAN CRISIS

Jungle, Thieves, and Worse: A Mom’s Epic Journey To Save Her Daughter

27-year-old Alejandra Jimenez recounts crossing the Darien gap in Panama with her two young children, the journey north, and the care they found at a New York City health center.

UNITED STATES

Everything For The American Dream

In many ways, Ciudad Juarez represents the last of a long list of obstacles in the extreme journey to reach the United States — and through that, to reach a job, the hope of better living conditions, and to let the imagination fly towards the American Dream.

 COLOMBIA

Healing At The Colombian Border

A community of those who have migrated and health care providers has emerged on Colombia’s eastern border.

The shipments contained 9.2 million defined daily doses of medication and supplies, including prenatal vitamins, surgical supplies, insulin and more.

This week, more than four tons of medicines, including antibiotics, antifungal medications, and painkillers, donated by Direct Relief, were received by the NGO Kurdistan Save the Children. The medications were distributed to local healthcare facilities, including hospitals, cancer treatment centers, and maternity centers, in collaboration with the Directorate of Medicines and Medical Supplies in the Kurdistan Region.

Personal Care Items Distributed in Isla Vista

On Friday, staff from AmeriCorps hosted a community coffee hour for unhoused community members in the Community Center in Isla Vista, California. Personal care kits, containing toothbrushes, shampoo, deodorant and other hygiene items, donated by Direct Relief, were distributed to attendees, as well as groceries and coffee.

Operational Snapshot

WORLDWIDE

Over the last week, Direct Relief shipped more than 7.9 million defined daily doses of medication outside the U.S.

Thirty-one pallets of requested medical supplies and medications departed Direct Relief’s warehouse in Santa Barbara, California, on March 15, 2024, bound for Ukraine.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 472 shipments containing nearly seven tons of medications during the past seven days to organizations, including the following:

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 4,864 shipments to 1,280 partner organizations in 53 U.S. states and territories and 54 countries.

These shipments contained 77 million defined daily doses of medication totaling 1.4 million lbs.

In the News

Should I Stay or Should I Go? Charities’ Response Amid Haiti’s Violent Unrest – Charity Watch

IOM and Direct Relief team up for crisis-afflicted migrants – InfoMigrants

Direct Relief awards $7 million in health equity grants – Philanthropy News Digest

Combat to Conquest: Vasil’s Path to Success – Let’s Levitate

In reality, everyone receives a gift at Plan A Health: quality medical care at no charge to the patient.

Plan A provides reproductive and primary care health throughout the Mississippi Delta, a region that historically has had poor health outcomes and low economic status. Their small team operates a mobile medical unit, outfitted with two exam rooms, that truck driver Antoinette Roby drives from city to city. Since its inception in 2018, Plan A has expanded to include a pharmacy, mail-order prescriptions, options for contraceptives, pre-and-post-natal care for patients with HIV, and telehealth for family planning. They’ve also hired a nurse practitioner that patients can call or text directly to ask questions.

While many initiatives were created to combat health disparities in Mississippi and have worked to increase access to care, the state still needs to catch up in adequate health measures. Mississippi’s government is one of the last states to consider expanding Medicaid. The State’s Health Department reported an increase in infant mortality in 2021, making Mississippi the state with the highest number of infant deaths in the country.

Related Content: In Rural Mississippi, Plan A Goes the Distance for Patients

Plan A’s brick-and-mortar site is in a small town within the Delta, within an unassuming building off the main road that was a previous physician’s office. Their next goal includes an expansion into rural Georgia, where health disparities mimic the Mississippi Delta.

“It’s really been a delight to see how it’s grown, it’s pretty cool,” said Dr. Caroline Weinberg, CEO of Plan A.

Weinberg is the only non-Mississippi native on the team. The New Yorker founded Plan A and has hired people from the communities that Plan A serves. In turn, they’ve built trusting relationships across the Delta and more than doubled their patient base in the first three years of operation.

“If you put the trust in the community, (and understand) that they know what they need, and that services delivered by the community for the community are so important,” she said. “And then empower the people in the community to deliver those services.”

The people she’s hired are also well-known community members, like Desiree Norwood, who is the mayor of her hometown of Sunflower, Mississippi. Norwood said when the mobile medical unit arrives in Sunflower, people are excited because Plan A has built a reputable reputation.

“A lot of organizations come into the community, and they do evaluations and research and then what happens? They leave,” she said. “We’ve actually been able to fill a lot of gaps and alleviate some of those barriers that they’re facing.”

Norwood said a lot of trust-building has happened because the team lives in the areas that they are serving. They endure the same barriers to success and have remained in the Delta to improve the conditions. Norwood is known for taking her personal vehicle during off hours to visit patients who have asked for emergency contraceptives or general health inquiries. The small-town mayor said there is no such thing as a “9 to 5” for her.

“This isn’t working a job, it’s a passion,” Norwood said.

Every Plan A employee shared the same sentiments. Roby recounted a time when she followed up with a patient whose blood pressure was too high and asked him to seriously consider their suggestions on lifestyle changes. Months later, the patient’s wife approached Roby and thanked her for the conversation; her husband had listened, made changes, and was in better health.  

Roby said that many uninsured people have neglected to attend doctor appointments and that some don’t know what to say or ask for when they meet with medical staff.

“You have to break it down and give them a better understanding,” she said. “Provide a higher level of patient care.”

Roby grew up in the Delta and said that the openness to learning about health conditions is growing. The driver of the mobile clinic said that parents are willing to learn about options for contraceptives for young adults and options for pre-natal and post-natal care with trusted physicians.

Roby said working at Plan A means a lot to her personally. She’s seen the effects of health disparities on her neighbors and wants to see better outcomes. She said that too often the people of the Delta have been overlooked for access to quality care.

“We never want anyone to have to choose between taking care of their family and getting the health care that they deserve,” Roby said.

While Plan A is a complement to other affordable health options in the area, some things set them apart. Plan A staff say they want to ensure that patients have options for their care. The health center offers variations of contraceptives and birth control for those who want to use the assistance. According to Weinberg, many women stop using birth control because of the side effects and the costly expense of making more appointments and purchasing new options.

At Plan A, patients can request the birth control that works for them.

Having direct access to a provider is a “big deal,” said Telvin Harrington, a community health worker at Plan A. He said that the community has embraced their team not only because they truly care, but because they can relate to the circumstances. Patients don’t have to wait 60 to 90 days for an appointment, and while transportation barriers are persistent in the area, the mobile clinic has scheduled stops so that residents know which days of the week they can receive care.

“Going to someone who looks like you, is relatable, and (can) build meaningful relationships with them, that’s important,” he said. “I come from a low-income family, and not all of my family members who have been sick have been able to afford healthcare…so just being able to see someone who is most relatable to your circumstance, it feels better.”

Direct Relief, through grant support from Organon, has awarded $800,000 to four clinics, including Plan A, which aims to address the drivers of unintended pregnancy in the U.S. through community-informed, collaborative approaches.

Pilar Gomez, DiabetesLATAM’s founder and director, started the NGO after moving to Panama in 2017. Until then, Gomez had worked as an instructional designer and project manager for Citigroup in Emerging Markets and as a freelancer designing training programs for Shell, Petrofac, Kaplan and Schlumberger in the U.S., UK, Latin America and Asia.

She also had a son and a daughter, and with time, they both were diagnosed with Type 1 diabetes.

“I met with one of the seven endo pediatricians in the country, asking her where the charities, summer camps and support groups were,” Gomez recalled. “She replied, ‘There is nothing in Panama and a lot to do.’”

Type 1 Diabetes In Panama

In Panama, there are currently 1,755 people with Type 1 diabetes. This is according to the Type 1 Index, a data simulation tool informed by published data and a survey of over 500 endocrinologists across the globe. The Type 1 index also estimates that 600 of these people in Panama are children.

Two government agencies run the public Panamanian healthcare system: (1) the paycheck-fueled Social Security (Caja de Seguro Social, or CSS) and (2) the Ministry of Health (MINSA) system, which is typically utilized by people who are unemployed and for those working in the informal sector and not registered as employed. There are also private hospitals that require private insurance or payment out of pocket.

Though treatment provided by both public options is equally comprehensive in theory, the reality is that the country’s health system is short-staffed, making it challenging to provide timely care. “They’ll say to you, yeah, we can get you an appointment, and you can pay $5,” said Gomez. “But the waiting list to see an endocrinologist can be five years. So effectively, there’s no coverage.”

There is also a severe shortage of medications throughout the year at the hospital network funded by the Social Security Fund. “If you read their list of medications, you’ll find all the different kinds of insulins, but you must go every month to collect your insulin. And one month, they might have insulin, but they don’t have test strips, the next month, they might have test strips, but they don’t have glucose meters. And then they don’t have one of the two types of insulins,” said Gomez. “So effectively, there’s no there’s no insulin and supply security.”

Pushing for Change

Gomez was determined to help — kids like her own needed reliable access to insulin. Through contacts at the International Diabetes Federation, she got in touch with the Life for a Child team, an Australia-based NGO that, in partnership with Direct Relief, provides insulin to young people in 45 under-resourced countries. 

When plans to provide insulin and education through a local hospital fell through, Gomez created a completely volunteer-run program separate from the hospitals for families that don’t have guaranteed insulin access. The program began in August 2022 with 30 kids enrolled, and in the last two years, it has grown to support 150 kids with diabetes care. That means that DiabetesLATAM now provides care for roughly 1 out of every 10 people living with Type 1 in Panama, according to the prevalence numbers from the Type 1 Index.

Given the importance of education in diabetes management, there are three education days each year. At the end of those days, the program participants receive the insulin and other medical products they need for the next four months. Snacks and lunches with the appropriate amount of sugar are provided, and education sessions are customized for the different age groups. Participant caregivers also undergo their education sessions. They also have a medical room where each kid is weighed, their A1c level (average blood sugar measurement) is checked, and their medical record is updated digitally. 

“What we’ve done is create a diabetes clinic because we see people every four months, which is roughly how often you’d see your doctor in the private sector,” said Gomez.

And recently, DiabetesLATAM garnered some public support from the Ministry of Health. On September 12, 2023, the organization participated in a public signing of a memorandum of understanding with Panama’s Ministry of Health, which was essentially an agreement to help expedite the complex process of importing donated medical products and support the organization’s outreach efforts.

What Now?

For Gomez and her team, advocacy begins with patient education and empowerment. On education days, caretakers are taught how to make the most of the 15-minute consultations provided by doctors in public systems. DiabetesLATAM has also introduced the use of insulin pens to patients. There are several benefits to using an insulin pen over using a vial and syringe: it increases dose accuracy, features less painful needles, and allows for easy insulin injection outside the home. 

Patients now talk about these new devices and research on their effectiveness with their doctors, helping them realize that pen use increases adherence to a treatment plan. “And so [the patients] become the people who open the mind of their doctors,” Gomez shared.

Her team recently used this time and ran focus groups to gather information for patient roadmaps that outline all the steps patients have to take if they need diabetes care and are a part of the Ministry of Health or Social Security system.

“When we do advocacy [with government officials], we take these documents with us,” said Gomez. “Some people say, ‘Oh, but those people have medical coverage, and at such and such hospital, there’s that insulin,’ and then we reply, ‘Yeah, but look at the roadmap for them; they have to follow 25 steps, they have to queue in the pharmacy for two hours, then they have to go back to the doctor for another stamp, then they need to wake up at four in the morning to do their lab work.’ So it [acceptable diabetes care] might be in writing, but this is in reality what people are going through.”

For Gomez, this was never about just handing off insulin. 

“Inevitably, when you get 400 people in the same space for eight hours, there’s something that changes within them, even if it’s very difficult to measure,” said Gomez. “I think you feel lonely battling the system, poverty, difficulty, sleepless nights. And then when you come together, and you realize that you’re one of many, something changes within.” 

“And I believe people become stronger, either to carry on living the way they are because they know that they’re not alone or to make certain changes and to approach their life and the system that they’re obliged to use in a different way.”

Since 2022, Direct Relief has provided DiabetesLATAM with over $950,000 worth of insulin and other medical products, as well as a double-door pharmaceutical-grade refrigerator for insulin storage.

Distribution of the 73 pallets has begun with the products resupplying field hospitals, mobile medical units, and primary health tents in shelters both in Rafah (Southern) and Deir al-Balah (Central) Gaza. The aid delivery also includes medications to benefit thousands of individuals with chronic diseases, cardiovascular ailments, and injuries, as well as prenatal vitamins and water purification tablets.

Medical items include:

• Diabetes medications and supplies for managing a chronic condition that affects thousands in Gaza
• Drugs to prevent heart failure for individuals suffering from cardiac conditions
• Syringes and needles for administering medications and providing necessary medical care in Gaza
• Sutures and wound care for treating injuries and ensuring proper wound healing in Gaza, where access to medical supplies is limited
• Prenatal vitamins for the health and well-being of pregnant women in Gaza, where access to proper nutrition is a challenge
• Personal protective gear for healthcare workers in Gaza to protect themselves and prevent the spread of diseases
• Water purification tablets and oral rehydration salts for preventing waterborne diseases and treating people for dehydration

As with previous shipments, this delivery to Gaza was the result of weeks of ongoing coordination with various national governments, international agencies, and on-the-ground organizations.

The medical aid that arrived today was airlifted to Jordan from Direct Relief’s California headquarters and distribution center earlier this month. Upon arrival in Jordan, the supplies were received by Anera, which arranged their transport to Egypt. From there, the 73 pallets were divided into three deliveries and driven across the border into Gaza.

The third and final aid truckload arrived safely this morning at Anera’s warehouse in Rafah, Southern Gaza, bringing much-needed aid to civilians facing a dire and still-unfolding humanitarian situation.

Anera, a key regional partner of Direct Relief, is a U.S.-based nonprofit with a longstanding, robust presence and record of providing humanitarian aid in Gaza, the West Bank, Jordan, and Lebanon.

By the numbers: Today’s shipment brings the total amount of aid delivered by Direct Relief to Gaza over the past five months to 37 tons and more than $24 million in value.

Regional assistance: Direct Relief supported Israel with both financial and medical material assistance in the wake of the deadly October 7 attack by Hamas, including equipping a 50-bed emergency medical field hospital, delivering dozens of emergency medical packs, and granting $1.6 million in financial aid for first responders and trauma and psychosocial support for survivors.

Direct Relief has also supported the efforts of Anera in the West Bank with 10 tons of requested medical items, including prenatal vitamins, IV solution, and more. Amid a rise in tension and conflict regionally, Direct Relief is responding to humanitarian needs across multiple locations, including Iraq, Jordan, Lebanon, Syria, and Yemen.

What’s next: Direct Relief is also continuing to work with its partners in Gaza and throughout the region to mobilize and coordinate the delivery of more requested medical aid.

This month, Direct Relief signed an agreement with the International Organization of Migration, which will strengthen both organizations to quickly respond to emergency needs, including those in Gaza.

Direct Relief, an apolitical, non-sectarian, and nongovernmental humanitarian aid organization, is committed to responding to health needs and requests for support in Gaza and across the region. All Direct Relief shipments to Gaza and elsewhere in the region will continue to be coordinated and delivered in accordance with U.S. sanctions laws and with necessary approvals from Israeli and Egyptian authorities.

The shipments contained 2.9 million defined daily doses of medication and supplies, including personal hygiene essentials, respiratory medications, vitamins and more.

Renowned Midwife Speaks for International Women’s Day

International Women’s Day drew a crowd of over 100 people to hear firsthand about the essential work of midwives from a midwife who responded to the 2022 floods in Pakistan to serve women who had little to no access to care.

Neha Mankani spoke at Direct Relief headquarters on Friday, shortly after a short documentary called “Neha,” which chronicles her efforts to bring midwifery care to communities impacted by the catastrophic floods in Pakistan’s Sindh Province, was shown to those gathered. A volunteer event was also held to pack personal care items for women worldwide.

In November 2023, Mankani was named among the “2023 BBC 100 Women,” highlighting inspiring and influential women from across the globe. Mankani was a Fulbright Scholar and earned a master’s in public health from Columbia University, a midwife and founder of Mama Baby Fund and works with the International Confederation of Midwives to shape policy and advocate for midwives globally.

Direct Relief often supports the work of midwives during emergencies because they are usually first responders to those most vulnerable, including pregnant women and infants. Direct Relief CEO Thomas Tighe introduced Mankani and said the organization works to connect resources to midwives in the wake of disasters for just that reason. “When we see an earthquake, or a typhoon… we’re thinking of midwives because they always show up,” Tighe said.

The documentary shows Mankani working to access clinics where demand for health services far outpaced capacity after the 2022 floods and showed the devastating impacts of climate on health. Afterward, Mankani was interviewed by Paulina Ospina, Direct Relief’s Maternal and Child Health Associate Director, and the two spoke about the significant intersections of climate change and the impacts on pregnant people and young children. For example, the impacts of heat can have direct implications for the prevalence of hypertension, pre-eclampsia, and even pre-term birth, Mankani said.

Environmental factors have direct impacts on women and children, including lack of access to quality food due to crop devastation from flooding and lost livelihoods for agricultural workers. Malaria and other vector-borne diseases are also related, as well as access to clean water and timely health care. Gender inequity and gender-based violence also add layers to women accessing care and resources.

“All of these disasters are set against an already weak health system,” she said. “It makes a poor situation worse.”

The documentary showed a scene of Mankani holding a listening session with midwives in Pakistan, asking them what they need to feel empowered in their communities to do their work safely and effectively. Because many policies around health care and midwifery are made at the Ministry of Health and country level, direct feedback from midwives is often left out of the conversation. But that’s changing, Mankani said, a fact that she finds extremely hopeful.

“There’s a sense of ‘nothing about us, without us’,” she said. “There’s a recognition that a lot of the change needs to come from the ground.”

Texas Wildfires

Historic wildfires have impacted Texas, with the largest being the Smokehouse Creek Fire, which burned over one million acres with 74% containment as of Friday, March 8, according to the Texas A&M Forest Service.

In response, a shipment of requested personal care items, medications, and supplies departed Direct Relief’s warehouse in Santa Barbara, California, and this week, it was bound for Amarillo, Texas.

Regence Health Network, a federally qualified health center, will use donations to treat patients with respiratory issues related to smoke inhalation and allergies.

NACHC President Visits Direct Relief

Last week, National Association of Community Health Centers President and CEO Dr. Kyu Rhee visited Direct Relief headquarters in Santa Barbara, California. Dr. Rhee met with Direct Relief leadership and staff to discuss the organizations’ partnership and combined impacts on patients in the U.S.

Operational Snapshot

WORLDWIDE

Over the last week, Direct Relief shipped more than 1.7 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 404 shipments containing nearly 13 tons of medications during the past seven days to organizations, including the following:

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 4,381 shipments to 1,248 partner organizations in 53 U.S. states and territories and 52 countries.

These shipments contained 67.8 million defined daily doses of medication totaling 1.3 million lbs.

In the News

Direct Relief celebrates International Women’s Day – KEYT

Teva’s ESG Lead on Why Company Committed to Community-Led Mental Health Push – PR Week

“Every day, our medical facilities are subjected to targeted attacks by Russia,” said Viktor Liashko, Minister of Health of Ukraine. “Each such attack endangers the lives of patients. Ensuring uninterrupted medical care under any conditions and being prepared for different scenarios is our main task in the realities of war.”

Attacks on the power grid in the winter of 2022-23 destroyed 61% of Ukraine’s electricity generation capacity and left around 12 million people without power, according to the UNDP.

Without electrical power, hospitals can’t pump oxygen to keep patients breathing, warm newborn babies in incubators, diagnose injuries with X-rays, or track patient care through electronic medical records.

“We are working to ensure that hospitals are equipped with everything they need and can continue to operate in the event of emergency power outages or complete blackouts,” Liashko said. “In particular, Ukrainian medical institutions are now provided with more than 10,000 generators for uninterrupted power supply. They have also begun to equip medical facilities with alternative and environmentally friendly sources of electricity, including solar panels. The initial 300 [electricity] storage systems received from Direct Relief will strengthen medical institutions in 20 regions of Ukraine. I am grateful to our international partners for this assistance.”

The war has inflicted an estimated $7.5 billion of direct damage on the electrical power sector, and has cost the sector $32 billion in lost revenue, according to the World Bank’s newly published damage and needs assessment.

The World Bank estimates it will cost $40.4 billion to rebuild Ukraine’s power sector over 10 years, using “a build back better approach with policies that align its energy model with the EU energy policy and move toward a decarbonized economy.” Of the $40.4 billion, $1.75 billion has been received.

“Ukraine has been using the [battery storage systems] since the first months of the full-scale war,” said Mykhailo Fedorov, Deputy Prime Minister for Innovation, Education, Science and Technology Development at Ukraine’s Ministry of Digital Transformation. “The systems provide backup power to hospitals, schools, emergency services and other critical infrastructure facilities. Thanks to our cooperation with Direct Relief, this year Ukraine will receive 2,000 devices as part of the Power for Health project. We continue to work on technological solutions for our country.”

Kharkiv, Ukraine’s second-largest city, was hit hard and relentlessly by artillery and air strikes in the opening stages of the full-scale war that began on February 24, 2022, and attacks have continued periodically over the past two years. The Kharkiv Regional Hospital serves the whole of the heavily war-damaged northeastern Kharkiv region, including its large population of internally displaced persons.

“But we never stopped working,” said Kostiantyn Loboiko, acting director of the hospital, which has 830 beds (including 130 in the maternity ward) and a staff of 2,000, including 550 doctors. “We also had births in the cellar, where we had some basic equipment.”

The greatest damage to the hospital to date occurred during three waves of missile strikes on the city on Dec. 29, which killed three people and injured 13. Around 90 of the hospital’s windows were blown out by a nearby impact, but only one person was injured at the site. “It was a miracle,” said Loboiko. 

The hospital has been developing its capacity to function autonomously since Russia first seized Crimea and supported a separatist rebellion in eastern Ukraine in 2014. This meant equipping the hospital with generators and its own well to ensure a water supply.

Now it is further building its resilience by adding batteries for storing electricity, purchased and donated by the Polish Government and Direct Relief, in coordination with Kharkiv-based Charity Fund Yevhen Pyvovarov. The hospital also plans to install solar panels to ensure the units work more efficiently in all seasons.

So far, eight units have been delivered to the Kharkiv hospital, with another two to four units to be added. The hospital has allocated four of those units to essential units like the emergency department, including surgery, traumatological and maternity units, and the cardiological center.

“If the Russians want to harm us, there will be a moment when the light flickers” as the batteries cut in, “and then work will continue,” said Loboiko.

In the town of Derhachi, five miles northwest of Kharkiv, two energy storage systems donated by the Polish government were installed last November at the local 100-bed hospital. These will give a further layer of energy security to the hospital, which like the Kharkiv Regional Hospital also uses generators in emergencies. “Now we can be sure that all operations will go ahead and that no patients are lost because of power outages,” said head surgeon Oleg Donchak.

Direct Relief’s battery donations to Ukraine fall at the intersection of two important programs. Direct Relief’s Power for Health initiative seeks to bring clean, renewable backup power to health facilities to ensure they can deliver critical healthcare services during power outages. The initiative has provided energy solutions for 41 healthcare facilities in California, Florida, Louisiana, and North Carolina, benefiting 1.3 million low-income patients. These projects have created an estimated $4.3 million in annual cost savings for the participating health facilities. Direct Relief has sponsored more than 100 power resiliency projects in 10 countries.

The donations are also part of Direct Relief’s extensive humanitarian medical aid program to the people of Ukraine since the start of the war in February 2022, the largest aid response in the organization’s 75-year history. Direct Relief has donated and delivered more than 1,900 tons of medical aid, with a wholesale value of $1.1 billion, to support the efforts of health workers and community organizations. The organization has also provided more than $42 million in financial assistance to groups offering essential health services, including rehabilitation services for war-injured people, psychosocial and mental health services, support of emergency, specialized, and primary care, and support for making health care mobile as people continue to move throughout the country.

“This expansive philanthropic support from Direct Relief has been possible only because of the generous contributions from of thousands of individuals, businesses, and organizations concerned about the welfare of Ukrainian people and wishing to support humanitarian health efforts,” said Direct Relief President and CEO Thomas Tighe. “We are committed to continuing our support as expansively as we can and as resources permit.”

Ukraine and its partners have worked since the start of the war to make the country’s energy system more resilient.

“Over the spring and summer, power utilities – aided by significant grants, loans and investment from a wide range of governments, multilateral donors and the private sector – undertook the biggest energy infrastructure repair and maintenance campaign in the country’s history,” according to a January report published by the International Energy Agency. “The Ukrainian government also strengthened its air defence systems and invested in passive defence measures such as engineering fortifications to further protect energy infrastructure.”

Still, attacks on the electricity grid continue. “Tens of thousands of people were without power after a barrage of two dozen Russian drones damaged energy infrastructure in the centre of the country,” AFP reported on Feb. 2. At least 79 missiles and drones have hit residential areas of Kharkiv since Dec. 29.

The shipments contained 7.2 million defined daily doses of medication and supplies, including personal care products, breast pumps, surgical materials, vitamins, and more.

Medical Aid Arrives in Sudan

Direct Relief continues to respond in Sudan as the civil war has impacted healthcare facilities and infrastructure, leading to protracted shortages of medicines and medical supplies.

Recently, a Direct Relief-supported organization, MedGlobal, distributed shipments of donated supplies, including oral rehydration salts, to local healthcare providers.

Since the civil war started in April 2023, Direct Relief has sent more than 37 tons of requested medicines and medical supplies, including prenatal vitamins, surgical materials, insulin, and personal care items, amounting to $8.7 million in wholesale value.

Direct Relief has been coordinating with the Federal Ministry of Health, World Food Programme, Sudanese Children’s Diabetes Association, International Society of Better Health Access, International Organization for Migration, International Society of Nephrology, and MedGlobal.

Direct Relief will continue to respond as needed.

Equipping Volunteer Firefighters in Mexico

Two weeks ago, Direct Relief delivered 10 field medic packs to local emergency response agencies in Oaxaca, Mexico, including the Comision Nacional de Emergencia, A.C., local firefighters and Protección Civil personnel.

This week, the packs were used by local forestry brigades for the treatment of injuries as the crews fought forest fires in Oaxaca. There are currently six active fires in the state at various levels of containment. Five volunteers have died in the efforts to contain the fires.

Mexico is currently experiencing a severe drought that is affecting its southern states. While states in northern Mexico are receiving significant rainfall due to the El Niño climate pattern, states in southern Mexico are seeing far lower levels of rain and higher frequency of fires in the mountainous regions of the country.

Direct Relief Signs Agreement with IOM

Direct Relief staff met with representatives of the International Office of Migration in Washington, D.C., this week to sign a memorandum of understanding to streamline and expand aid delivery globally to migrant communities.

Beyond immediate relief efforts, the partnership will strengthen emergency preparedness and response activities, including the stockpile and pre-position medical supplies in collaboration with IOM host countries.

“Our partnership with Direct Relief opens doors to resources that are vital for delivering urgent medicines and supplies to those in need, particularly in moments of crisis,” said Ugochi Daniels, IOM’s Deputy Director General for Operations. Central to this landmark partnership is the provision of medicines, medical equipment, and healthcare supplies. This critical assistance will strengthen IOM’s capacity to respond swiftly to the acute health needs of migrants and mobile populations during humanitarian and public health emergencies.

“Direct Relief is so pleased to join in partnership with IOM to help address the tremendous humanitarian health needs that exist among the world’s migrants and the communities that host them,” said Thomas Tighe, Chief Executive Officer of Direct Relief. “Private, philanthropic resources have always been an important part of the humanitarian assistance efforts for migrants, and we look forward to extending a broader invitation to participate — in a productive, efficient manner through coordination with IOM, which will optimize all available resources and best serve people in need.”

To read the full announcement, click here.

Monitoring Texas Wildfires

Five active fires are currently impacting the Texas Panhandle, north of Amarillo. As of February 29, the Smokehouse Creek Fire has burned a total of 1,078,807 acres (3% contained), making it the largest fire in the state’s history and second largest in U.S. history. The fire is threatening to converge with the Windy Deuce Fire to the southwest, putting the town of Borger, which currently sits in between the two fires, at extremely high risk.

Direct Relief’s Research and Analysis team is monitoring and mapping the real-time mobility of those displaced by the fire, social vulnerabilities, and power outage impacts. Click the image to view the updated map here:

Operational Snapshot

WORLDWIDE

Over the last week, Direct Relief shipped more than 5.9 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 527 shipments containing over 3 tons of medications during the past seven days to organizations, including the following:

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 3,963 shipments to 1,206 partner organizations in 53 U.S. states and territories and 51 countries.

These shipments contained 64.9 million defined daily doses of medication totaling 1.2 million lbs.

In the News

Better Health Support for People in Crisis Situations Under Direct Relief Agreement – IOM

A Maui Community Health Center Receives a Down Payment to Rebuild and Recover after Devastating Wildfire – National Association of Community Health Centers

‘Fortnite’ Raises $144 Million for Ukraine Aid Over Two-Week Span – Aol.com

The Annual Guardian Games Cup Returns – Bungie

BU Theatre Department Puts on ‘Three Sisters’ Play – Binghamton University Pipe Dream

Direct Relief’s Fund for Health Equity Awards $7 Million to 38 Organizations Across the U.S. – 3BL

Medical Aid To Ukraine Dwindling With News Fatigue: US Healthcare And Medical Providers – We Must Do More – Med City News

“This latest round of more than $7 million in grants, made possible by generous support from MacKenzie Scott, the AbbVie Foundation, and Eli Lilly and Company, is the most recent infusion of funding for organizations deeply committed in eliminating health disparities and improving healthcare quality in their communities,” said Dr. Byron Scott, Direct Relief COO and Co-Chair of the Fund for Health Equity. “Direct Relief is proud to support and grateful for the work they do every day.”

The AbbVie Foundation committed $10 million over five years to the Fund for Health Equity in 2020.  Since then, the AbbVie Foundation distributed grants to twenty organizations, and this year, the foundation is awarding $1.6 million in grants to 10 organizations, including: Central City Concern, Edward M. Kennedy Community Health Center, Family Health Centers of San Diego, Food Well Alliance, Kee Cha-E-Nar Corporation, Mexican American Opportunity Foundation, Minority Behavior Health Group, National Black Nurses Association, University of Texas – El Paso, and Vecinos, Inc.

“The AbbVie Foundation is proud to support the 2024 Fund for Health Equity grant recipients and we’re grateful for their work addressing health disparities in historically marginalized communities across the United States,” said Claudia Carravetta, President, AbbVie Foundation; Vice President, Corporate Responsibility & Global Philanthropy, AbbVie. “We believe meaningful change begins with communities, and we look forward to listening and learning from all our grant partners who are identifying innovative solutions that further advance health equity.”

Lilly also supported the Fund with a $5 million commitment in early 2021 as part of its Racial Justice Commitment, a robust endeavor to deliver resources like education, health care, economic stability, and jobs within the communities where it operates. Direct Relief distributed a portion of this initial funding to eight awardees across the U.S. since 2021.

This year, $880,000 from Lilly’s commitment will be split between four new awardees: Denver Health and Hospital Authority, Cheyenne River Youth Project, GirlTREK, Asian and Pacific Islander Wellness Center.

“Lilly’s commitment to social impact goes back nearly 150 years and we remain committed to eliminating disparities that prevent people from living the healthiest life possible today,” said Cynthia Cardona, Head of Social Impact at Lilly. “We sincerely appreciate Direct Relief’s efforts to identify and contribute to worthy organizations that are working to create real change in their local communities around the U.S.”

Since the start of the Fund in 2021, more than $50 million has been provided to support 160 organizations across the U.S.

The awardees were selected by the Fund for Health Equity’s Advisory Council, which includes the following members:

• Co-Chair Regina Benjamin, MD, MBA, 18th US Surgeon General of the United States, Founder Bayou Clinic, Inc.
• Co-Chair Byron Scott, MD, MBA, Direct Relief COO
• Martha Dawson, DNP, MSN, RN, FACHE, President and CEO President of the National Black Nurses Association, Associate Professor at the University of Alabama at Birmingham
• Jane Delgado, Ph.D., MS, President and CEO of the National Alliance for Hispanic Health
• Gail Small, JD, Head Chief Woman, a citizen of the Northern Cheyenne Tribe

Full list of 2024 Awardees:

• Alabama Interfaith Refugee Partnership, Birmingham, AL
• Asian and Pacific Islander Wellness Center, Inc., San Francisco, CA
• Camarena Health, Madera, CA
• Central City Concern, Inc., Portland, OR
• Centro Hispano de East Tennessee, Knoxville, TN
• Cheyenne River Youth Project, Inc., Eagle Butte, SD
• Children’s Village, Birmingham, AL
• Denver Health and Hospital Authority, Denver, CO
• DuPage Health Coalition, Carol Stream, IL
• East Harlem Council for Human Services, Inc., New York, NY
• Edward M. Kennedy Community Health Center, Inc., Worcester, MA
• Family Health Centers of San Diego, Inc., San Diego, CA
• Family Reach Foundation, Boston, MA
• Food Well Alliance, Inc., Atlanta, GA
• GirlTREK Incorporated, Washington, DC
• Health Outreach Prevention Education, Inc. (HOPE), Tulsa, OK
• Hispanic Health Coalition, Inc., Houston, TX
• Kee Cha-E-Nar Corporation, Klamath, CA
• La Plazita, Inc. DBA La Plazita Institute, Albuquerque, NM
• Los Barrios Unidos Community Clinic, Inc., Dallas, TX
• Mexican American Opportunity Foundation, Montebello, CA
• Minority Behavioral Health Group, Akron, OH
• Multi-Cultural Health Evaluation Delivery System, Erie, PA
• National Association of Hispanic Nurses, Inc., Lexington, KY
• National Black Nurses Association, Silver Spring, MD
• Native Action, Inc., Lame Deer, MT
• REACH, Las Vegas, NV
• Santa Cruz Barrios Unidos, Inc., Santa Cruz, CA
• Shared Harvest Foundation, Inc., Culver City, CA
• Tell Every Amazing Lady about Ovarian Cancer (T.E.A.L.®), Brooklyn, NY
• The Concilio, Dallas, TX
• The Night Ministry, Chicago, IL
• The Texas International Institute of Health Profession DBA VCare Clinics, Houston, TX
• University of Texas Foundation/University of Texas
• Vecinos, Inc., Cullowhee, NC
• Vida Senior Centers, Washington, D.C.
• Vincent Chin Institute/Asian Health Services, Oakland, CA
• Virginia Garcia Memorial Health Center, Aloha, OR

This new $10 million commitment is a focused expansion on tribal communities of Direct Relief’s Power for Health initiative. The initiative provides philanthropic support to ensure resilient power and operational continuity for nonprofit health facilities in high-risk-of-outage areas to ensure critical services are maintained, including during weather-related emergencies in which health risks are heightened.

Healthcare services are highly dependent on power being available to access electronic health records, maintain medications that require refrigeration, operate basic diagnostic equipment, and to keep the lights on. The Power for Health initiative already has provided funding of $44 million to support resilient power for 130 projects globally, including at 56 U.S. nonprofit clinics and health centers.

“Direct Relief has seen the increasingly common situation of power losses during emergencies leaving safety-net health facilities unable to function and provide care when needed most for patients without other options. Many tribal communities face intensified health risks due to already limited health care access as well as power availability, high energy costs, and more frequent outages,” said Thomas Tighe, Direct Relief CEO.

The $10 million investment is aimed specifically at achieving several objectives:

• Operational Continuity: Helping ensure that tribal health centers can continue to provide essential services during power outages.
• Economic Relief: Alleviating the burden of energy costs that weigh down on health facilities, making healthcare provision more sustainable.
• Strengthened Healthcare Safety Nets: Fortifying healthcare infrastructure within tribal communities.

The critical need for investment in resilient energy infrastructure on tribal lands is underscored by findings from a recent Department of Energy report, which sheds light on the acute electricity access and reliability challenges confronting tribal areas that are further compounded by the escalating threat of climate change-induced weather events.

According to the report:

“Climate-related threats to Tribal infrastructure are expected to increase in frequency and severity under future climate scenarios, thus being highly vulnerable to impacts associated with climate change. These climate change vulnerabilities have motivated Indian Tribes to explore options for distributed clean energy solutions.”

Other key findings from the report include:

• Tribal communities experience 6.5 times more power outages than the broader United States.
• 10 percent of on-reservation households spend more than 20 percent of their income on energy while the average US household spends less than 3 percent.
• The Department of Energy – Office of Indian Energy is only able to fund 30 percent of tribal project applications. Seventy percent of proposed projects are unable to be funded.

Direct Relief’s commitment to tribal clean energy is a response to this urgent need, aiming to mitigate these challenges through sustainable and resilient power solutions.

As a purely philanthropic initiative, grants are provided to cover the full costs of designing and installing solar and battery systems, which are then owned and maintained by the recipient tribal health organization. All financial benefits accrue to the recipient organizations.

“Direct Relief recognizes that many creative financing options exist for solar and battery projects in the U.S., but we believe this is a very strong case for philanthropic support and a compelling value-for-money proposition to enhance health services for people facing tough circumstances,” said Tighe. “The basic difference is the same as between a student loan and a scholarship – both are ways to pay for college, but one is paid back and other is not. Direct Relief’s approach is that of scholarship, not a loan, which we believe is appropriate for a charitable organization.”

Like most natural disasters, Hurricane Otis grabbed headlines in late October as a Category 5 storm that produced record-setting wind gusts of 205 miles per hour. The storm killed at least 52 people, with dozens more missing, according to the official government count. Local outlets have placed the death toll at as high as 350 people.

Now, several months later, international media has moved on even as the deadliest phase of the storm is ongoing. In the hurricane’s immediate aftermath, lack of potable water, limited or no electricity, impassable roads and damaged infrastructure, and interruptions to local food and medicine supply chains were the most pressing issues. Today, the delayed progress in rebuilding efforts has created a breeding ground for mosquitoes.

Dengue fever, also known as break-bone fever, is a viral mosquito-borne infection that can lead to painful fevers, rashes, and low platelet counts, which reduces the ability of the body to stop bleeding. While there is no cure, many cases can be treated with over-the-counter medications and rest. However, more difficult cases require anti-hemorrhaging medication, platelet transfusion, and an array of interventions in an ICU. In the most severe cases, usually due to low platelet counts, which can lead to spontaneous blood loss, patients are transferred to hospitals in Mexico City.

The mortality rate is less than 1%, though the illness can quickly fill up hospital beds. This is reflected at a new field hospital in Acapulco, where most patients are being treated for dengue fever, according to Dr. Ivan Santana, Guerrero state’s director of medical emergencies.

Months after the storm, “there still is a lot of debris and garbage, including trees, wood, sheet metal, aluminum, mud, and dust in the hurricane-effected areas (Guerrero state). It has become a breeding ground for mosquitoes,” said Dr. Santana, who noted that some roads in poorer, more rural parts of the state remain blocked.

Santana said there were about 1,500 active dengue fever cases in Guerrero as of last week, with just about all of them concentrated in areas most impacted by Hurricane Otis. He said cases were on the rise prior to the storm — Ministry of Health figures show a case count increase of almost 340% through October 2023 compared to all of 2022 — but that the numbers in Guerrero jumped significantly post-Otis. “Dengue is also present in other Mexican states, but Guerrero has the highest number, and I believe this is due to the hurricane,” he said.  

Less than two weeks after the storm, Guerrero had 1,855 confirmed cases, representing a 50% year-over-year increase in the number of cases compared to the same period the previous year. Between January 1 and February 21 this year, Guerrero had 1,497 confirmed cases, part of more than 4,700 total suspected cases, according to PAHO. These case counts are more than the total number of dengue cases in the state from January 1 to October 23, just before Otis hit last year.

Overall, since the storm, Guerrero has seen a 237% increase in cases compared to the same period the previous year, according to Ministry of Health data. Nationwide, Guerrero has about 40% of all confirmed cases, which is down from the 75% of all Mexican cases it had at the end of January. Before the storm last year, Guerrero was not among the top five states in dengue case counts.

Assessing the current healthcare priorities in Guerrero, Santana said dengue fever is at the top, even as other maladies are present, such as other mosquito-borne diseases, including chikungunya and Zika, as well as diarrheal diseases. Santana also mentioned that people with cancer and chronic diseases, such as diabetes, chronic kidney disease, and hypertension, have faced interruptions to care due to a lack of access to their medicines and treatments at facilities. Violent crime has also persisted in Guerrero, which has also curtailed the number of physicians and other first responders willing to travel to the area, according to Santana and one additional doctor who asked to remain anonymous and who decided to suspend his medical missions to Guerrero.

“Hospital infrastructure was damaged, and services were cut. Pretty much every single medical facility was affected by the hurricane so that obviously creates some issues,” Santana said. He mentioned the lack of cold chain capacity as an example of why diabetics were unable to get insulin, for example. Other medications that require being kept at low temperatures, like some vaccines, also spoiled.

Addressing what led to the recovery effort delays, Santana said the scale of the disaster was simply too large to address quickly, given available resources.

“More than 500 trucks were moving rubble right after the storm. There was lots of heavy machinery, but the magnitude of the hurricane was so massive that you couldn’t quite do it fast enough,” he said. “It was too much for any quick response to mobilize. There was too much rubble and mud, and even now there’s mud, which is a breeding ground for mosquitos.”

In the past couple of weeks, Santana said that the outbreak has been somewhat curtailed because of favorable weather conditions, specifically meager amounts of rain, as well as more fumigation. Santana believes the situation will stabilize through the spring, but that cases will likely rise again during the rainy summer months, in addition to fumigation machinery needing to be returned to the other Mexican states from which they have been loaned.

Since Hurricane Otis made landfall in Oct. 2023, Direct Relief has shipped more than 67 tons of medical aid to support health services for those impacted by the storm.

Interview translation and additional reporting by Eduardo Mendoza

Apart from the devastating human losses, the damage inflicted on Ukraine over these past two years is immense: according to the World Bank’s newly published damage and needs assessment, as of December 31, 2023, the total cost of reconstruction and recovery in Ukraine is $486 billion over the next decade.

In health care, the damage has been near-ruinous in the most war-affected parts of the country. Overall, the health sector has so far sustained approximately $1.4 billion in damage, rising to a staggering $17.8 billion if including the removal of debris, demolition of destroyed facilities, and other losses.

Of the 9,925 public facilities in the sector prewar, 1,242 have been partially or fully damaged. The destruction was especially severe in the eastern Donetsk and Luhansk regions, and the neighboring Kharkiv region, which also borders Russia. Additionally, 787 pharmacies were damaged or destroyed.

The dire health care situation was exacerbated by the huge movement of people since the start of the war. In addition to the 6.5 million people who have fled and remain outside of Ukraine since February 2022, an estimated 3.7 million remain internally displaced, placing a huge strain on healthcare facilities in more protected parts of the country.
While many refugees have since returned to their country, the humanitarian crisis and human tragedy are deepening as attacks on Ukraine’s energy infrastructure, homes, and health facilities continue to kill and injure people and cause widespread psychological trauma.

Against this stark backdrop, Direct Relief ramped up the largest humanitarian aid response in its 75-year history and has continued to assist its core partners in Ukraine, including the Ministry of Health, with more than 1,900 tons of medical aid, valued at $1.1 billion wholesale, to support the efforts of health workers and community organizations. The organization has also provided more than $42 million in financial assistance to groups offering essential health services in response to the prolonged crisis.

As the war continues, Direct Relief is focused on rehabilitation services for war-injured people, psychosocial and mental health services, support of emergency, specialized, and primary care and support for making health care mobile as people continue to move throughout the country, and resilient power to sustain continuous health services.

Financial Summary

The information included in this report, by necessity, includes unaudited figures because the organization’s formal audit coincides with its fiscal year, which is from July 1 to June 30. Audited figures for this period will be included when that audit and report are completed. Numbers are as of Feb. 13, 2024.

Who Donated to the Response?

In response to the crisis, Direct Relief received contributions from 105,033 donors totaling $115,067,879 from individuals, foundations, businesses, and organizations located in 84 countries (including the U.S.). Donations from all 50 U.S. states and four territories were received.

Of the total amount of Ukraine Relief-designated contributions —
• $42,194,219 was contributed by 104,358 individuals
• $61,267,946 was contributed by 314 businesses
• $10,426,607 was contributed by 212 foundations
• $1,179,107 was contributed by 149 organizations

How Were the Funds Used?

Of the total Ukraine Relief-designated cash contributions received to date, Direct Relief has expended or committed $68,763,863 to improve the health and lives of people affected by the disaster.

This includes:

• $42,358,000 on financial assistance to entities and organizations supporting emergency response
• $16,556,544 on procurement of alternative power and backup batteries, field medic packs, specialized requested equipment and other supplies
• $5,372,683 on transportation (paid and pending)
• $4,476,636 on emergency personnel costs and other organizational response management expenses

Consistent with Direct Relief’s Donation Policy, 100 percent of funds received for specific emergency events are devoted entirely to those events, and none of the funds donated for the Ukraine response have been used for fundraising.

(As explained here, all Direct Relief's fundraising expenses are paid by the Direct Relief Foundation, which uses earnings on previously received bequests to the organization for this purpose and other non-programmatic costs.)

Medical Material Assistance

Direct Relief’s Ukraine relief response support can be divided into three categories: medical material assistance, direct financial assistance, and information assistance.

Direct Relief’s main objective in any large-scale disaster response is to deliver emergency medical resources safely and securely – requested, approved by the responsible government authority, and appropriate for the circumstances – where they are most needed, as fast and efficiently as possible.

In January 2022, prior to the start of the war, Direct Relief had been working in coordination with Ukraine’s Ministry of Health to import specialized Covid-19 monoclonal antibody therapies, a donation that established a key relationship that would provide a channel into the country weeks later under wartime conditions.

After the war broke out, Direct Relief was in constant communication with local, regional, and country-level organizations, including the Ministry of Health, to determine needs and requests for aid.

Direct Relief’s first emergency shipment consisted of field medic backpacks outfitted with triage tourniquets and other specialized equipment for first responders treating injuries of war.

As more requests became known, Direct Relief began to channel large volumes of aid via charter flights to the region as part of the response.

In March, a 76-ton charter, with transportation donated by FedEx, included specifically requested emergency medicines and supplies, including trauma and wound care products, chronic disease medications, oxygen concentrators, and Covid-19 antiviral tablets. A subsequent 52-ton charter departed in June, and FedEx also provided funding for many of the emergency medical backpacks sent.

As of Feb. 21, 2024, Direct Relief’s Ukraine relief response efforts have resulted in the delivery or pending delivery of 1,900 tons of medical aid, valued at $1.1 billion wholesale, to support health services.

As the response continued, Direct Relief began to focus on emerging needs:

REHABILITATION SERVICES

Both military troops and civilians have endured wartime injuries, and many require significant medical interventions to repair trauma and physically rehabilitate. Supporting rehabilitation and recovery from war injuries, both physical and psychological, has been a central tenet of Direct Relief’s financial support strategy in Ukraine.

People needing complex surgeries, long-term rehabilitation and prosthetics have sought care at Unbroken National Rehabilitation Center in Lviv. Direct Relief granted $1 million to Unbroken to procure rehabilitation equipment, develop treatment protocols, and train rehabilitation personnel.

Direct Relief has also provided $250,000 to UNITED24 for renovating the Mental Health and Rehabilitation Center Veterans “Lisova Poliana” in the Kyiv region of Ukraine. The center specializes in treating disorders related to combat stress, assisting survivors of captivity and torture, and providing physical rehabilitation services.

The Protez Foundation connects Ukrainians living with amputations to customized prosthetics and rehabilitation and is another organization Direct Relief supports. While Protez has recently opened a clinic in Ukraine, some patients are flown to the U.S. as a reprieve from the combat environment and are fitted for prosthetics. They spend at least three weeks, sometimes more, learning to use their bionic limbs and have access to familial-like support through the Ukrainian-American community.

Read more: Rehabilitation Effort in the Twin Cities Helps Ukrainians Recoup from War

Direct Relief has also been able to connect amputees with high-intensity prosthetic lower limbs, or running blades, equipment that is generally not covered by the Ukrainian health system. Access to these advanced prosthetics is drastically changing the lives of many victims of the war who thought their injury had put an end to their sporting activities or ability to serve their country.

RESILIENT POWER

War-time power interruptions can greatly impact health services, so Direct Relief has focused on providing resilient power options to Ukraine. The organization has provided more than 2,000 Tesla Powerwalls - rechargeable 13.5 kW lithium-ion batteries that can provide power during peak times, outages, and at night - to help keep healthcare and educational facilities operating during disruptions to the national power grid. This is a direct response to previous Russian attempts to destroy Ukraine’s energy supply during the coldest months.

Memories are still fresh of power cuts, with surgeons operating by flashlight during relentless missile and drone attacks last winter. Building on a separate project to supply more than 500 Powerwalls donated last year by the Polish government, this further installation of Tesla units will make a huge difference going forward.

In the town of Derhachi, five miles northwest of Kharkiv, two Powerwalls donated by Poland were installed last November at the local 100-bed hospital to supplement its generators in emergencies.

The impact of the combined lines of support is amply evident on the ground in Ukraine’s hardest-hit cities like Kharkiv. Here, assistance rendered via Direct Relief’s partners, as well as aid received from other international organizations, ensures quality health care for hundreds of thousands of people.

"We are grateful for all assistance with medicines, medical supplies, and electrical power. We wouldn't have survived without such support," said Kostiantyn Loboiko, the acting director of the Kharkiv Regional Hospital, which has 830 beds, a staff of 550 doctors and serves the whole of the heavily war-impacted Kharkiv region.

MENTAL HEALTH SUPPORT

About one-third of Ukrainians may be affected by mental health issues, with up to 15 million in need of psychosocial support and 3–4 million of those requiring direct pharmacological interventions by mental health professionals, according to a United Nations Development Program report issued in June 2023. Mental health is an integral part of Direct Relief’s Ukraine response, cutting across many categories of work: medicine donations, primary care, rehabilitation aid, care for refugees and more.

The organization has funded psychosocial support programs for war-affected people, including through Razom's "Together with You” program in July 2022, providing psychological help to impacted individuals, including children. Direct Relief has provided $550,000 in funding to Razom for Ukraine for this program.

Razom currently provides care at seven centers in Lviv, Ivano-Frankivsk, Vyshkiv, Khmelnytskyi, Bucha, Kharkiv and Dnipro, where teams of experienced psychologists work with different age groups and specialize in different types of psychological trauma. In addition to individual therapy sessions, the specialists conduct group sessions at centers for displaced persons, hospitals, rehab facilities, geriatric institutions, and orphanages.

Direct Relief has also supported HromadaHub, a nonprofit providing humanitarian medical supplies to medical facilities throughout Ukraine and providing emergency psychology treatment. A key project supported by Direct Relief in 2023 was its emergency psychology training for Ukrainian psychologists and members of the state civil defense service to improve care for the civilian population after military attacks, disasters, and other traumatic events.

Outside of Ukraine, Direct Relief has also funded programmatic efforts of the League for Mental Health, which provided mental health outreach to Ukrainian refugees in Slovakia.

PRIMARY CARE AND HEALTH SYSTEM STRENGTHENING

Direct Relief is engaged in several different lines of activity to bolster health care in Ukraine. In areas where rural geography and the impact of war have curtailed access, support for primary and specialized community outreach health services, expanding capacity for early diagnosis, treatment, and prevention of disease. At the same time, access to medicines is being ensured through a vetted network of non-governmental partners capable of providing regular distribution to primary health facilities and community pharmacies.

Direct Relief is continuing to support emergency, specialized, and primary health care services through the provision of funding, ambulances, medicines, and supplies in Ukraine.

Outside of Ukraine in support of primary healthcare services, Direct Relief provided funding for prescription medication support and telehealth services for Ukrainian refugees in Poland. Poland-based organization Pelion had, by the end of 2023, supported 318,000 Ukrainian refugees to purchase medicines under its Health4Ukraine program, or 18% of the total number of people that came to Poland after the war's start.

In Depth

Amid Freezing Temperatures, Ukrainian NGOs Double Down on Humanitarian Projects for 2024

Ukraine Starts Unpacking Mental Trauma as War Rages On

Tesla Powerwall Shipment Fires Up Ukraine’s Energy Fight Before Winter

Direct Financial assistance

Thanks to the outpouring of financial support from donors, Direct Relief continues providing cash assistance to help facilities and organizations effectively respond to the ongoing needs of patients impacted by the war.

To date, Direct Relief has identified, vetted, and awarded emergency financial support totaling more than $42 million in cash support for groups responding to medical needs related to the war.

Funding has been focused on the following categories and organizations:

Medical material to Ukraine

• Ukraine’s Ministry of Health - $2.2 million - Granted funds to the Ukrainian government to facilitate and sustain medical logistics operations in-country through December 2023. Supported facilitation of medical logistics operations around controlled medicines in-country.
• Charity Fund Modern Village and Town - $810,000 - Bolstered the operational costs of this Ukrainian nonprofit, which has worked with Direct Relief since 2015 and provides humanitarian medical supplies to medical facilities to Ukraine’s Cherkasy region.
• Fondation Humanitaire Internationale AICM Ukraine - $500,000 -Funded operational costs as the group delivered medical aid to support 150 medical facilities concentrated in the northeast of Ukraine.
• Charitable Fund Humanitarian Hub Zhytomyr - $490,000 - Funded operational costs, including payment of the formerly all-volunteer staff, of this Ukrainian nonprofit providing humanitarian medical supplies to over 40 medical facilities in Sumy, Chernivtsi, Luhansk, Dnipro, and Kharkiv oblasts since the beginning of the conflict.
• Charity Fund "TAPS" - $390,000 - Supported the Ukrainian non-profit’s mission of the families of fallen soldiers, which they do in part by distributing medicines and medical supplies to those in need. Funding went to support their operational costs, as well as the purchase of an electrohydraulic operating table requested by the surgical team in a nearby hospital.
• HromadaHub - $370,000 - Strengthened operational needs of this Ukrainian nonprofit, providing emergency psychology treatment as well as humanitarian medical products to medical facilities in Luhansk, Donetsk, Zaporizhia, Kharkiv, Odesa, and Chernivtsi oblasts.
• Polish National Agency for Strategic Reserves (RARS) - $350,000 - The Polish Government appointed RARS to act as a humanitarian hub for medical aid intended for Ukraine. RARS has worked with Direct Relief to support the forwarding of shipments into Ukraine and to store medical aid safely.
• Kharkiv Renovation Fund - $320,000 - Funding supported the operational costs of this Ukrainian nonprofit providing humanitarian medical supplies to medical facilities throughout Ukraine.
• Yevgen Pyvovarov's Charity Fund - $300,000 - Funding backstopped operational costs of this Kharkiv-based Ukrainian nonprofit that began in 2020 as an initiative designed to provide humanitarian medical supplies to medical facilities throughout Ukraine.
• Charitable Organization Ukrainian Soul - $230,000 - Funding went to support the operational costs of this Ukrainian nonprofit providing humanitarian medical supplies to medical facilities throughout the eastern parts of Ukraine. The organization also supports an outpatient center for internally displaced people in Ukraine.

Rehab services

• First Lviv Medical Union (National Rehabilitation Center Unbroken) - $2,870,000 – This medical center in Lviv, Ukraine, provides comprehensive rehabilitation services. Funding was used for the organization of the First National Rehabilitation Conference in April 2023, education of specialists, equipment for the newly established rehabilitation center, surgical equipment, renovation of the pediatric neurosurgery department, rehabilitation of the in-patient psychiatry department, and support towards the establishment of a burn center.
• Society of Critical Care Medicine - $2.5 million – SCCM is the largest critical care nonprofit organization globally - a global community of clinicians who provide care to critically ill or injured patients in over 100 countries. Members in Ukraine and the surrounding countries have identified critical medical aid needed for people affected by the ongoing war. The funding was used to train nonsurgical Ukrainian clinicians on how to care for trauma patients more effectively and efficiently, moving patients more quickly from the ICU to lower levels of care to free up critical ICU capacity.
• The Protez Foundation - $1,135,000 – Funding was used for prosthetics and the education of prosthetists from Ukraine.
• Levitate Technology ApS - $585,000 – Funding provided prosthetics for patients in Ukraine in collaboration with the Unbroken and the charitable organization, U+.
• Charitable Organization West Support in Ukraine - $500,000 - Bolstered CO West Support in Ukraine to support the infrastructure and resource development of the Tsybly Center to expand rehabilitation services.
• Dobrobut Hospital - $500,000 - Funding supported the biggest network of private medical facilities in Ukraine, which has been providing free medical services during the war. The funding was used for the provision of surgical and rehabilitation care.
• United24 - $250,000 – Funding was used for improving the capacity of the Mental Health and Rehabilitation Center Veterans “Lisova Poliana” in the Kyiv region of Ukraine.

Health services

• Dobrobut Hospital - $2 million - Funding supported the biggest network of private medical facilities in Ukraine, which has been providing free medical services during the war.
• Society of Critical Care Medicine - $1.5 million - Supported a global community of clinicians who provide care to critically ill or injured patients in over 100 countries. Members in Ukraine and the surrounding countries have identified critical medical aid needed for people affected by the ongoing war. The funding was used to provide training and procure small equipment needed most urgently by intensivists in Ukraine.
• Charity Fund Yevgen Pyvovarov - $280,000 – CF Yevgen Pyvovarov, in close coordination with the Association of Nephrologists in Ukraine, as well as the European Renal Association Task Force for Ukraine, has used the funding to provide batteries for patients in Ukraine who use peritoneal dialysis for their chronic renal condition, as well as specialized medicines and lab supplies.
• Charity Fund Modern Village and Town - $270,000 - The Charity Fund Modern Village and Town and the largest children's hospital in Ukraine NCSH OHMATDYT create a multidisciplinary mobile teams of hospital specialists to provide affordable consultative, diagnostic, medical and psychological and, if necessary, inpatient care in any remote area of the country.
• Razom for Ukraine - $180,000 - Funding supported for specialized services (medical missions) - A Ukrainian-American nonprofit established in 2014 to support the people of Ukraine.
• Ukrainian Diabetes Federation - $150,000 - Organization for advocacy and awareness of diabetes in Ukraine. This in-country organization distributes medical equipment and monitors where people who need insulin are located and where they are fleeing. The funding was used for operational costs - distributing material aid and gathering and sharing vital information.
• Ukrainian Midwives Union - $150,000 –Funding will support basic training on first aid, medical childbirth outside of hospital settings, and perinatal and postnatal care.
• Dobrze Urodzeni (Well Born) - $140,000 - Polish organization of midwives, doulas, psychologists, and lactation consultants that focuses on independent midwifery practice and out-of-hospital perinatal care. Grant funds were given to develop and assemble birth kits and distribute them in Ukraine.
• Tabletochki Charity Foundation - $130,000 – Tabletochki is the largest Ukrainian childhood cancer foundation. The funding was used to cover tumor molecular and genetic testing for pediatric oncology patients in Ukraine.
• Motanka - Mobile Medical Services - $120,000 - Franco-Ukrainian nonprofit organization dedicated to supporting war victims in Ukraine. These funds committed by Direct Relief will allow Motanka to procure medical and personal care products, surgical equipment, and medicines for doctors and surgeons on the frontline of the war.

Emergency services

• Crown Agents - $500,000 - Funding was for purchasing generators on behalf of the Ministry of Health.
• KIWI K.A.R.E - $300,000 – Kiwi K.A.R.E, a registered New Zealand Charitable Organization, provided medical and general humanitarian aid and evacuations; support to IDPs with a focus on children living in orphanages and refugee centers; supply continuity of wide-ranging medical aid; an outreach program and support to physical and psychological rehabilitation centers; power infrastructure support (heaters, small power banks, generators).
• UA Brokers without Borders - $300,000- Grant funding was for the purchase of 15 generators for hospitals in need of backup power.
• UA Resistance Foundation - $300,000 – Funding supported the transportation of U.S. ambulances, fire engines, and supplies into the hands of medical and fire personnel in Ukraine
• Razom for Ukraine - $250,000 - Supported payment of costs for generators, and $180,000 for specialized services and medical missions.
• Project Joint Guardian - $130,000 – Supported this group of full-time firefighters from around the world who volunteer their time to help their fellow first responders better serve their communities during both man-made and natural disasters, including responding in Ukraine.
• Charity Fund Yevgen Pyvovarov - $35,000 – the CF Yevgen Pyvovarov, in collaboration with the Ministry of Digital Transformation, has supported the transport of donated back-up power systems for Ukraine. The funding was used towards the transport and installation of the back-up units.

Mental health

• Razom for Ukraine - $550,000 - A Ukrainian-American nonprofit established in 2014 that, with this funding, is providing mental health services to war-impacted individuals in Lviv and Ivano-Frankivsk, Ukraine.
• HromadaHub - $320,000 - A Ukrainian nonprofit providing humanitarian medical supplies to medical facilities throughout Ukraine and, with this funding, is providing emergency psychology treatment.
• Health Tech Without Borders - $100,000 - A global non-profit, Health Tech Without Borders (HTWB) serves as an innovative hub that connects qualified and vetted volunteer clinicians to survivors of humanitarian disasters, war, or assault. Since the beginning of the war on Ukraine in 2022, HTWB has provided critical tools, resources, and technology to overwhelmed and under-resourced healthcare workers. The funding was used to enhance the team’s capacity to engage, recruit, and train new volunteers.

Health care for refugees

• Doz Fundacja Dbam O Zdrowie (Pelion) - $15 million (Poland)- A Polish healthcare company that, with this funding from Direct Relief, is providing digital cash payment cards to Ukrainian refugees to help cover their healthcare cost
• League for Mental Health Slovakia - $3,700,000 – Supported mental health services and employed Ukrainian mental health specialists working with the Ukrainian refugee community in Slovakia. Part of the funding was also used to provide local transportation for Ukrainian citizens residing at a temporary housing in Slovakia.
• Fire Medical - $600,000 (Slovakia)- Operational funding provided to an ambulatory services nonprofit that acts as an out-patient clinic and operates hospital transportation services free of charge for refugees.
• International Confederation of Midwives - $583,000 - Funding provided for midwifery services for refugees over a period of 12 months, supporting the Midwife Associations in the following seven countries: Estonia, Finland, Czech Republic, Hungary, Latvia, Poland, and Romania.
• HealthInova North Macedonia - $200,000 – Provided pharmacy and medical services vouchers to cover the most immediate needs for Ukrainian patients in Macedonia.
• URTICA Foundation Poland - $120,000 – Supported children in oncological and hematological wards around Poland. Since the war broke out in Ukraine, and millions of Ukrainians were forcefully displaced, the Foundation started providing psychosocial support services for pediatric oncology patients from Ukraine as well. The funding was used to expand the provision of services throughout Poland.
• Polish Diabetes Association - $100,000 (Poland) - Patient association in Poland committed to diabetes education and advocacy. The funding was used to provide pharmacy and food vouchers to cover the most immediate needs to Ukrainian diabetes patients in Poland.

Information Assistance

In addition to the provision of medical material and financial aid in response to the crisis, Direct Relief has been a critical supplier of information. Working with software company partners, academic institutions, and medical centers, Direct Relief has used crowdsourced data, geospatial analysis, and other data collection and analytics instruments to help understand key issues in the war.

Within Ukraine, Direct Relief has focused mainly on assisting with crowdsource data collection on the needs of internally displaced persons, including their origins and destinations, access to key services and goods including health care, food, water, shelter, and livelihoods, and their sentiment in terms of subjective concerns.

At the same time, Direct Relief collected data on the needs and goods availability of over 950 private pharmacies throughout Ukraine, including many located in areas of significant conflict. The pharmacy data has been incorporated into the cross-validation of MOH needs lists. Important insights were shared with first responders, healthcare partners, and Ukrainian health officials, as well as with United Nations agencies and international assistance organizations to help them determine how to best prioritize and deploy their respective resources.

Supporting Ukrainian Refugees

Direct Relief’s principal role in providing information assistance for the refugee crisis in the European Union and Moldova comes through the analysis of human mobility data. Analysis of this data allows for an improved understanding of refugee movements at granular time and space scales for the sake of resource planning and allocation across several different sectors of activity. This analysis has been performed through Direct Relief’s CrisisReady partnership with Harvard University School of Public Health and shared broadly with a range of agencies who have requested specific types and locations of analysis.

Key analysis-sharing partners include the World Bank, UNICEF, UNHCR, IOM, the Health Cluster, Mercy Corps, and others. In partnership with Meta, Direct Relief is in the process of assembling an EU-based research network that is capable of supporting municipal-level analyses, with the immediate focal point of that effort being support for a collaboration between UNHCR and the city government of Budapest which aims to understand changes in refugee clustering throughout the city for the sake of housing retrofits for long-term refugees.

Corporate Support

Direct Relief was able to supply a large array of medical material support without the expenditure of donor funds due to the medical product donations from healthcare manufacturers and distributors, many of which Direct Relief works with on an ongoing basis.

Healthcare company donors responded expansively to requests for their participation. Included among them are 3M, Abbott, AbbVie, Accord Healthcare, Amgen, Apotex, AstraZeneca, Baxter, Bayer, BD, BioMarin, BMS, Boehringer Ingelheim, Carlsbad Technology, Cencora, Corza Medical, Edenbridge, Eli Lilly & Co., Embecta, Genmab, Gilead, Grifols, GSK, Haleon, Henry Schein, Hikma, ICU Medical, Integra Lifesciences, Janssen, Jazz Pharma, J&J, Kenvue, Liquid IV, McKesson, Medline, Merck & Co., Merck KGaA, Pfizer, Sandoz, Takeda, Teva, Ultragenyx, Unilever, Unite to Light, Vertex, Viatris, and Westminster.

The war continues, with no end in sight, and medical needs remain urgent as attacks continue. Direct Relief remains committed to providing support to strengthen local health systems, as well as to a number of focus areas in Ukraine.

As the response continues, Direct Relief remains able to provide support as a result of its existing strong relationships with non-governmental organizations that were already receiving Direct Relief medical product shipments, ongoing work with clinical experts in the field to guide distribution and procurement decisions, existing partnerships and contracts in place to quickly request and receive high-quality medications from pharmaceutical manufacturers and distributors, and a strong track record of shipping large volumes of product, including those requiring cold chain packaging and storage, to difficult-to-access places to reach the most vulnerable patients.

Direct Relief is focusing on these areas for long-term recovery by directing funding and medical product support for the continued strengthening of the health system.

The Maui wildfires inflicted widespread devastation on the Maui community, underscoring the critical need for comprehensive healthcare services in the aftermath of such disasters. Acknowledging the pivotal role Mālama I Ke Ola Health Center plays in the community, Direct Relief’s historic grant aims to empower the health center to provide essential healthcare resources, support immediate medical needs, and enhance overall capacity to serve the affected community.

Recognized for its commitment to transparency, efficiency, and accountability, Direct Relief provides targeted assistance to communities in need, regardless of politics, religion, or ability to pay. Direct Relief has been a steadfast supporter of Community Health Centers across the United States, demonstrating a strong commitment to improving healthcare access for underserved populations. Identifying the crucial role that Community Health Centers play in providing comprehensive and affordable healthcare, Direct Relief has collaborated extensively with the National Association of Community Health Centers (NACHC) to amplify their impact.

“NACHC is deeply appreciative of the generous grant to Mālama I Ke Ola Health Center,” said Kyu Rhee, MD, MPP, President and CEO of NACHC. “The human toll and tragedy that Lahaina residents experienced from the wildfires will take a long recovery. The funding will allow Mālama I Ke Ola Health Center to rebuild infrastructure, provide essential services to the community and help affected island residents heal. Community Health Centers, such as Mālama I Ke Ola Health Center, reach beyond the walls of the exam room to address island health disparities that include higher rates of chronic disease and premature death from environmental factors, including natural disasters. We are grateful for our longstanding partnership and collaboration with Direct Relief to support Community Health Centers as they carry out their mission as the first and last frontline responders to disasters and devastation.”

Through its work with NACHC, Direct Relief aims to address the unique challenges faced by Community Health Centers, ensuring they have the necessary resources to deliver quality healthcare services. This collaboration includes targeted assistance, such as medical donations, financial support, and logistical assistance, tailored to meet the health center’s specific needs.

Direct Relief’s support extends beyond individual grants, with the organization actively engaging with NACHC to advocate for policies that strengthen the Community Health Center model and enhance its ability to serve vulnerable communities. By fostering these strategic collaborations, Direct Relief aims to bolster resilience and effectiveness nationwide.

The organization’s commitment to Community Health Centers aligns with its broader mission to improve health outcomes for individuals affected by poverty and emergencies. Direct Relief recognizes the critical role played by Community Health Centers in delivering healthcare services to those who need it most and remains dedicated to supporting and enhancing their capacity to make a lasting impact on community health.

“This investment underscores our commitment to supporting Community Health Centers and their indispensable role in delivering healthcare to those who need it most, especially during times of crisis,” stated Thomas Tighe, Direct Relief CEO. “Direct Relief is privileged to support the work being done by Mālama I Ke Ola Health Center, as they continue to serve the community of Maui following the devasting fires in August of last year.”

As a Community Health Center, Mālama I Ke Ola Health Center plays a vital role in delivering accessible and quality healthcare services to underserved populations. The grant from Direct Relief is intended to facilitate Mālama I Ke Ola Health Center’s recovery efforts, including the restoration of facilities, provision of medical supplies, and reinforcement of the healthcare infrastructure required to meet the evolving needs of the community. The funding will further amplify the health center’s ability to address the specific challenges faced by vulnerable communities affected by the island’s wildfires.

“We are incredibly grateful for the generous $1 million grant from Direct Relief, which comes at a pivotal moment as we continue our work to address the immediate and long-term needs of our community,” said Cassie Savell, Mālama I Ke Ola Health Center COO and Deputy CEO. “This substantial contribution will allow us to significantly enhance and expand our support and services, ensuring those affected by the fires receive the care and resources they need during this challenging time. Together, with Direct Relief’s support, we are committed to rebuilding and healing our community, demonstrating the power of collaboration and compassion following the Lahaina fire devastation.”

The shipments contained 10 million defined daily doses of medication and supplies, including wound care products, cardiovascular drugs, diabetes management supplies, vitamins, and more.

Solar Installation Complete at Nepali Hospital

In 2015, a devastating earthquake struck Nepal, killing over 8,000 people and leaving thousands more injured and in dire need of help. Post-earthquake, the country’s medical infrastructure was not left unscathed. A report issued by Nepal’s Ministry of Health and Population noted that 375 of the 446 public health facilities and 16 private facilities in Nepal’s hardest-hit regions were destroyed.

To help respond to urgent health needs, Direct Relief quickly coordinated with corporate partners as well as established local and emergency response partners to send pallets full of requested medicines and medical supplies to healthcare facilities. In the decade since the earthquake, Direct Relief has supported the health system, including by providing funds to Nepali NGO Mountain Heart Nepal for the construction of Siddhasthali Rural Community Hospital, a 15-bed facility in southern Nepal. The project has been steadily making progress over the last three years, and now the hospital is set to open on April 1, 2024.

Direct Relief has also equipped the new facility with a medical oxygen plant and cold-storage capacity, as well as a recently-installed backup solar system. The solar energy system is producing electricity with surplus energy going back to the electrical grid. This surplus energy is credited back to the hospital by the Nepal Electrical Authority, thus generating extra income for the hospital.

California Storm Preparations Underway

California is bracing for another set of storm systems to move through the state over the next week, which could bring flooding and landslides in its wake. Two atmospheric rivers will bring more than five inches of rain to various parts of the state, with the heaviest impacts expected in Northern California and along the Central Coast.

In advance of the storms, Direct Relief has been in communication about potential needs with state and regional primary care associations, search and rescue organizations across the state, the Medical Reserve Corps, and other first responder groups. The organization maintains a medical inventory of medications and supplies commonly requested during emergencies, including flooding.

The latest storm system is one in a series of atmospheric rivers to inundate the state, and Direct Relief has been responding to ongoing requested for groups experiencing impacts from flooding. In February, Direct Relief dispatched multiple immediate shipments of requested aid to partner organizations across the state. An emergency health kit, a large cache of essential medicines and supplies often requested after disasters, was shipped to Los Angeles to support a damaged health facility that had lost supplies due to flooding.

Also dispatched were field medic packs, filled with items for triage care outside of clinic walls, and personal care kits, packed with hygiene items like soap, toothbrushes, and toothpaste, that departed Direct Relief’s warehouse for distribution to organizations and health facilities across the state. California Emergency Medical Services Agency (Cal EMSA) also received 40 requested field medic packs for teams deployed throughout the state in response to the storms.

The organization will continue to respond to the latest storm system as needs become known.

Operational Snapshot

WORLDWIDE

Over the last week, Direct Relief shipped more than 6.5 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 588 shipments containing over 14 tons of medications during the past seven days to organizations, including the following:

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 3,140 shipments to 1,089 partner organizations in 52 U.S. states and territories and 47 countries.

These shipments contained 52.4 million defined daily doses of medication totaling 547,723 lbs.

In the News

Humble Bundle Surpasses $250 Million Raised for Charitable Causes Around the Globe – TechPowerUp

Direct Relief Navigates Medical Aid to Yemen and Sudan Through Red Sea Shipping Attacks and Sudan’s Civil War – ReliefWeb

Turkey and Syria Earthquakes: One Year Later – ReliefWeb

Jaguar Health Donates Supply of Mytesi to Humanitarian Aid Organization Direct Relief – Yahoo! Finance

The bitter weather is a nuisance for most but can create dangerous health and living conditions for the nation’s growing, unhoused population. Chicago experienced severe cold weather in mid-January, coupled with a wind chill, or the rate of heat loss from exposed skin, at 40 degrees below zero, according to the National Weather Service. Experts in cold-weather states and working with people who are unhoused are addressing health concerns, but say the number of people with housing needs is growing.  

The frigid temperatures increase the risk of frostbite, and wounds on extremities are more frequent for people sleeping outside and those walking long distances.

“For me, when it snows in the morning, my day is disrupted because I have to drive in the snow and my commute is a little bit longer. But for [people who are unhoused], those challenges are tenfold, sometimes 100-fold, because where they stay is outside,” said Nedda Elewa, President of Street Medicine Detroit. “They stay in the cold, they stay on the streets, even those who are fortunate enough to find themselves in a bed in a shelter, that’s not guaranteed every night.”

Street Medicine Detroit provides quality medical care for Detroit, Michigan’s unhoused population. Elewa, who is also an MD candidate at Wayne State University School of Medicine, said that Street Medicine Detroit provides wound care during the colder months: frostbite, laceration repairs, infection prevention and control, and dressing changes. Elewa says these health conditions are in addition to the many chronic diseases they try to provide care for, including hypertension, asthma, and diabetes.

“Sometimes the treatment is just getting them into a warm space, which is a challenge a lot of times,” she said.

Others patients need more intensive interventions like surgery. However, most don’t have access to consistent medical care, due to social barriers like lack of identification, reliable transportation, and cell phones.

Social issues have compounded the nation’s housing and homelessness challenges.

In New York, local government has shifted policies around homelessness, like suspending the Right to Shelter rule, which requires a bed for those in need, and implementing a 60-day rule, requiring houseless people to reapply for shelter space after 60 days. The changes followed an influx of migrants in the city, who were expected to find shelter in an open field with minimal personal space. The city was already facing mass evictions after national, Covid-related housing protections were dropped and housing affordability decreased.  

“Housing instability definitely increased significantly after all of those protections were gone,” said Nathalie Interiano, Director of Policy and Advocacy at Care for the Homeless in New York, adding that the increase in homelessness over the last year and a half has been “pretty significant.” That’s concerning to Care for the Homeless, which provides health care, advocates on behalf of, and houses New York’s unhoused population.

“Health issues are so intricately linked with the population that we specifically serve,” Interiano said. “People who are dealing with unstable housing are also dealing with a variety of other health issues.”

The nationwide point-in-time count was conducted in late January. The count identifies the number of people sleeping outdoors on a single night and is used to inform federal policymakers on the scope of homelessness across the nation. In December 2023, the Department of Housing and Urban Development forewarned that the numbers from the January 2024 count would be 12% higher than in previous years.

However, some experts say the count doesn’t share the full scope of homelessness, since it is not a controlled study and is limited to those sleeping outside rather than houseless individuals and families who constantly sleep in different locations.

In 2023, New York’s point-in-time count for households experiencing homelessness was 59,572 and individuals totaled 103,200. Over 53,000 unhoused people in New York are in families with at least one child. Even though the city has over 173,000 beds year-round for families, adults, and children, they are spread out across the city and don’t always have space at each location for an entire family or individuals who would like to stay together.

Others may not want to be in a shelter environment. “Some of (the) reasons why people enter into homelessness or housing insecurity situations are attempting to find means of safety,” said Carol Sharp, President and CEO of the Night Ministry in Chicago. “That means the difference between visualizing a safe space inside of a home versus a safe space. And having the freedom to move at will and freedom to find people (who) might have similar circumstances and finding comfort in that.”

In Chicago, the Night Ministry served 600 more individuals in 2023 than previous years. Sharp said that Chicago is experiencing similar issues around homelessness as other cities, including limited affordable housing. However, she noted that people looking for a “safe space” also include those who experience mental illness or misuse substances, people who have experienced domestic violence, people who identify as transgender and non-binary, veterans, and those living with HIV/AIDS.

In Illinois, almost 1,500 homeless people were identified as having experienced domestic violence, according to HUD. The Night Ministry makes a point of meeting people where they are, using mobile units and volunteer physicians to see patients on the streets of Chicago and at partner-affiliated buildings. Similar to organizations in Detroit and New York, they treat wounds, frostbite, Covid, and influenza, and provide care for chronic diseases during the severely cold months.

Direct Relief supports health facilities and organizations across the U.S. focused on street medicine, including Street Medicine Detroit, Care for the Homeless, and the Night Ministry.

Direct Relief currently has two ocean containers heading to the Red Sea – one en route to Yemen’s capital Aden carrying a broad range of hospital supplies, and another headed for Port Sudan on the Red Sea’s western shore, packed with insulin and other supplies for children with diabetes.

“We need to figure out a way to get into these dangerous places, otherwise we wouldn’t be doing our job,” said Gordon Willcock, Direct Relief’s deputy director of emergency response. “There’s a correlation between the needs and the level of insecurity, and in most cases that means logistics are challenging.”

“We work with people who know their territories and know their jobs, and we take their advice and make informed decisions,” Willcock said. “We’re not going to be foolhardy or cavalier, we have a responsibility to our donors and to ensure the security of the supply chain.”

While shipping continues through the Red Sea, options have diminished and costs have risen sharply as insurers demand steep premiums for covering ships that pass near Yemen. The original cost of shipping the Yemen-bound container from California’s Port of Long Beach to Aden was just over $6,200, but a $3,000 “Red Sea Charge” was later added, raising costs by nearly 50%. For Sudan-bound containers, carriers have imposed a $1,500 “contingency surcharge” to cover the increased security risk.

Although attacks by Yemen’s Houthi rebel group have been disrupting Red Sea shipping since November, the situation has recently deteriorated. On Jan. 26, Maersk, the world’s largest container ship operator, notified customers that it was suspending shipping through the Red Sea, citing new intelligence information about heightened security risk. Maersk is rerouting ships around South Africa rather than using the Suez Canal shortcut connecting the Red Sea with the Mediterranean.

Shipping from Europe to Port Sudan by going around Africa rather than through the Suez Canal into the Red Sea adds 10-14 days to the journey, driving up costs and reducing global shipping capacity.

“The situation currently remains untenable, and we encourage customers to prepare for complications in the area to persist and for there to be significant disruption to the global network,” Maersk said.

“It’s one less carrier we can get quotes from if we need the shipment to move through the Red Sea/Gulf of Aden for a shorter transit time,” said Alisa Harnish, associate director of transportation at Direct Relief.

Direct Relief works with logistics firms like Scan Global Logistics to manage the shipping process, including finding vessels to deliver the cargo. The firm continues booking transit through the Red Sea, but many ship owners refuse to pass that way.

While ships transiting the Red Sea and the broader region around the Horn of Africa have long been vulnerable to piracy, the largest container vessels “have traditionally been difficult to attack due to the primitive boats being used historically,” said Anders Thorsen, director of Aid, Relief & Government Services for North America at Scan Global. “Of course, the attacks are different now and [it is] really difficult to defend against missile attacks. Due to this, we also see as lot of owners / masters refusing to pass through Suez due to the dangers involved.”

Yemen Aid

Yemen has long been considered one of the world’s worst humanitarian crises, suffering through nearly a decade of civil war, with almost half of its 35 million people having limited or uncertain access to food.

The shipment en route now to Yemen contains a broad range of medical supplies including prenatal vitamins, electrolytes for hydration, surgical drapes and masks, and concentrated surface disinfectant for hospitals, which will be delivered to medical teams in Yemen operated by the NGO MedGlobal.

Last year, Direct Relief delivered donated medicine to Yemen with a wholesale value of $4.7 million, including cardiovascular and gastrointestinal drugs, hormones, wound care products, central nervous system agents, anti-infective agents, vitamins and more. Direct Relief works in the country with Yemen Aid, a Yemeni-American development organization. The supplies were successfully delivered to Yemen Aid and subsequently distributed in coordination with the Ministry of Public Health and Population to public health facilities across the country to meet specifically identified needs.

Sudan Insulin Supply Chain Remains Open, But In-Country Situation is Challenging

The Red Sea turmoil has also raised costs for a crucial program on the western shore of the Red Sea: providing donated insulin for Sudanese children with type 1 diabetes, in partnership with Life for a Child.

When civil war erupted in Sudan last April, it cut off imports of the insulin that 11,000 Sudanese children with diabetes depend on to stay alive, said Dr. Salwa Musa, a pediatric endocrinologist with the Sudanese Childhood Diabetes Association (SCDA), which provides donated insulin and related supplies at pediatric diabetes clinics all over the country.

Until April, all of Direct Relief’s diabetes donations were flown into Khartoum International Airport. On April 15, the Rapid Support Forces militia seized control of the airport, which still remains out of operation. The RSF also looted the SCDA’s insulin storage facility in Khartoum, destroying a two-year supply.

No new insulin arrived in Sudan until October, when a shipment arranged by Direct Relief arrived via a new route – by ocean into Port Sudan.

“Not a lot of freight forwarders were willing to have their craft dock at Port Sudan,” said Kelsey Grodzovsky, who leads Direct Relief’s diabetes programs. “There were a lot of issues getting anyone to transport the supplies to the country. So instead of going big and sending a lot of supplies up front, we did more of a test shipment. Since it proved effective, we’re widening the supply chain, continuing to ship aid in larger volumes.”

After the successful delivery in October, several others were dispatched. A container of blood glucose meters, test strips and pen needles arrived in Port Sudan on Jan. 31, and a large shipment of insulin and insulin delivery devices is scheduled to arrive in Port Sudan by late March.

More containers are being prepared, but Direct Relief is shipping material to Sudan in smaller quantities than would be ideal to reduce risk as the country’s civil war continues. In December, the RSA militia seized control of Sudan’s second-largest city, Wad Medani, putting about 1,000 of SCDA’s childhood diabetes patients out of reach. “The Sudanese civil war is brutal, devastating and shows no sign of coming to an end,” said a February overview published by Chatham House.

“The security situation is extremely challenging,” Grodzovsky said. “We’re not bulk shipping the insulin because of the security situation, so that if something happens, we’re not losing a whole annual supply.”

The shipments contained 12.9 million defined daily doses of medication and supplies, including prenatal vitamins, wound care supplies, surgical essentials and more.

Responding to California Storms

California experienced two back-to-back atmospheric rivers, with the second causing widespread damage from flooding and high winds. An estimated 520 mudslides have occurred in Los Angeles alone, resulting in nine deaths. Authorities are warning of the prolonged danger of landslides as the weather has eased, but has left the ground unstable.

In response, Direct Relief dispatched multiple immediate shipments of requested aid to partner organizations across the state. Field medic packs, filled with items for triage care outside of clinic walls, and personal care kits, packed with hygiene items like soap, toothbrushes, and toothpaste, departed Direct Relief’s warehouse this week in Santa Barbara, California, for distribution to organizations, including R.OA.D.S. Community Care Clinic, Universal Community Health Center, and the Children’s Clinic.

Earlier this week, direct Relief delivered additional shipments of requested supplies to healthcare centers in San Diego, including YMCA San Diego and Imperial Beach Community Clinic. California Emergency Medical Services Agency (Cal EMSA) also received 40 requested field medic packs for teams deployed throughout the state in response to the storms.

The organization will continue to respond as needs become known.

Monitoring Chile Wildfires

Since February 1, multiple fires have impacted central and southern Chile. An intense heatwave and dry conditions led to the burning of 14,000 homes and more than 64,200 acres of land in Valparaiso and Viña del Mar, according to the Pan American Health Organization (PAHO).

Direct Relief is in direct communication with PAHO and Fundacion FEDES on emerging needs related to this event. This week, PAHO will ship ten Direct Relief field medic packs and additional emergency supplies to Chile.

Operational Snapshot

WORLDWIDE

Over the last week, Direct Relief shipped more than 11.4 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 272 shipments containing over six tons of medications during the past seven days to organizations, including the following:

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 2,421 shipments to 988 partner organizations in 51 U.S. states and territories and 41 countries.

These shipments contained 40 million defined daily doses of medication totaling 462,143 lbs.

In the News

How to help California victims of atmospheric river floods – FOX Weather

Direct Relief and Red Cross help storm victims up and down the coast – KEYT

Volunteers help with sand bags in Montecito – KEYT

Since the fires started on August 8, 2023, Direct Relief has sent more than 25 tons of requested medicines and medical supplies, including vaccines, insulin, inhalers, emergency medical backpacks, and personal care items, to 22 organizations, amounting to $1.8 million in wholesale value.

Financial Summary

The information included in this report, by necessity, includes unaudited figures because the organization’s formal audit coincides with its fiscal year, which is from July 1 to June 30. Audited figures for this period will be included when that audit and report are completed. Numbers are as of Feb. 6, 2024.

Who Donated to the Response?

In response to the crisis, Direct Relief received contributions from 13,338 donors totaling $5,368,632 from individuals, foundations, businesses, and organizations located in 21 countries. Donations from all 50 U.S. states, Washington, D.C., and two territories were received.

Of the total amount of Maui wildfire-response designated contributions —
• $2,971,659 was contributed by 13,244 individuals
• $1,457,170 was contributed 47 businesses
• $908,083 was contributed by 33 foundations
• $31,720 was contributed by 14 organizations

How Were the Funds Used?

Of the total Maui wildfire response-designated cash contributions received to date, Direct Relief has expended or committed $3,935,922 to improve the health and lives of people affected by the disaster.

This includes:

• $2,550,000 on financial assistance to organizations supporting emergency response
• $804,231 on procurement of field medic packs and other supplies
• $456,427 on emergency personnel costs and other organizational response management expenses
• $125,264 on transportation (paid and pending)

Consistent with Direct Relief’s Donation Policy, 100 percent of funds received for specific emergency events are devoted entirely to those events, and none of the funds donated for Maui wildfire response have been used for fundraising.

(As explained here, all Direct Relief's fundraising expenses are paid by the Direct Relief Foundation, which uses earnings on previously received bequests to the organization for this purpose and other non-programmatic costs.)

Medical Material Assistance

Direct Relief’s wildfire response support can be divided into three categories: medical material assistance, direct financial assistance and information assistance.

Direct Relief’s main objective in any large-scale disaster response is to safely and securely deliver emergency medical resources – requested, approved by the responsible government authority, and appropriate for the circumstances – where they are most needed, as fast and efficiently as possible.

Direct Relief leaned into pre-existing relationships to begin immediate support. In the first few days of the wildfires, Healthy Mothers Healthy Babies, a grantee through Direct Relief’s Fund for Health Equity, reached out for assistance with medicines and supplies. This resulted in the first shipment of field medic packs for triage care as the group sent medical providers into Maui from neighboring Oahu.

As recovery continued, Direct Relief began to channel requested aid into ongoing shipments. As of Feb. 6, 2024, Direct Relief’s Maui wildfire response efforts have resulted in the delivery or pending delivery of 123 shipments of requested medicines and medical supplies, including vaccines, insulin, inhalers, emergency medical backpacks, and personal care items, worth about $1.8 million, wholesale, to 23 organizations.

Supporting Public Health Efforts with Cold Chain Logistics

Over the past six months, Direct Relief’s relationships with local groups, its strong partnership with corporate donors, and its ability to securely deliver large quantities of medical goods – including temperature-sensitive products that require the use of cold-chain supplies and technologies – have resulted in the organization becoming a targeted channel for the delivery of medical goods to benefit people in Maui recovering from the fires.

Direct Relief continues to fulfill requests, including shipments of Covid vaccine in coordination with Hawai'i's Department of Health. Direct Relief became the primary distributor and logistics partner for the Hawai’i State Department of Health’s vaccination campaign and health fair for individuals and families affected by the fires. (Direct Relief first established a partnership with the Department of Health during pandemic surges and shipped specifically requested PPE during that response.)

Direct Relief has since supported 13 healthcare providers in Hawai’i with Covid, flu, RSV, pneumococcal, and tetanus vaccines, along with portable refrigerators, freezers, and temperature monitoring devices, inventory readily on-hand, to support cold-chain storage and distribution within the island more completely.

Protecting Residents Returning to Burn Areas

Direct Relief has responded to numerous wildfires and has often been asked to help minimize potential re-entry activity-related hazards. This was also the case in Maui for residents returning to burn areas. After fires, impacted areas may contain unstable structures, sharp metal objects, and ash with potentially toxic substances, so having protective gear and equipment is of critical importance. Direct Relief became the sole provider of PPE and reentry supplies for the Department of Health in the weeks following the fires.

To support safe reentry for Lahaina fire-impacted property owners and residents, beginning in September, Direct Relief fulfilled a state Emergency Management Agency request for 20,000 PPE re-entry kits.

Direct Relief shipped PPE items to Maui, which were assembled into kits by local volunteer organizations on the island. The kits included coveralls, shoe covers, nitrile gloves, work gloves, protective goggles, and N95 masks. Direct Relief also shipped specifically requested chemical-resistant gloves and P100 masks to the Department of Health for people who needed additional protection.

The kits were made available when people registered for entry passes and have been distributed by nonprofit organizations such as Healthy Mothers, Healthy Babies.

After the first 20,000 kits, the Maui District Health Office (state Department of Health) requested an additional round of reentry kits for distribution through the end of 2023.

Read More

Hawai’i Wildfires

‘Aloha and Trust.’ Native Hawaiʻian Health Care’s Response to Maui Fires

Hawai’i Wildfires

Prioritizing Health of Body and Mind for Maui Wildfire Survivors

Hawai’i Wildfires

Maui Health Fair Aims to Reach Residents Recovering from Fires

Direct Financial assistance

Thanks to the outpouring of financial support from donors, Direct Relief continues providing cash assistance to help facilities and organizations effectively respond to the ongoing needs of patients impacted by the wildfires.

To date, Direct Relief has supported groups working in Maui with $2,550,000 in funding to strengthen response, recovery, and resiliency efforts and continue to support local, community-based organizations that have established relationships with the community, collaborate with other nonprofit organizations on the island, and demonstrate a long-term commitment to support those impacted by the wildfires.

Recipients of the funding include Maui Search and Rescue, Malama I Ke Ola Health Center, Hui No Ke Ola Pono, Project Vision Hawai'i, and Healthy Mothers, Healthy Babies Coalition of Hawai'i.

Information Assistance

In addition to providing medical material and financial aid, Direct Relief has been a critical information supplier to key organizations involved in the response. Working with technology companies, academic institutions, and health providers, Direct Relief has used human mobility data, geospatial analysis, and other data collection and analytics instruments to help understand key issues.

The organization’s data-driven tools, such as wildfire mapping applications and the CrisisReady initiative in partnership with Harvard, offer insights into wildfire risks and social vulnerability. Direct Relief and CrisisReady produced several reports monitoring population displacement caused by the fires, which were shared with first response agencies to inform resource allocation and situation reports.

Corporate Support

Direct Relief was able to supply a large array of medical material support without the expenditure of donor funds due to product donations from healthcare manufacturers and distributors, many of which Direct Relief works with on an ongoing basis.

Healthcare company donors responded expansively to requests for their participation. Included among them are 3M, Abbott, AbbVie, Accord Healthcare, Apotex, AstraZeneca, Barebones Living, Baxter International, Becton Dickinson, Boehringer Ingelheim, Chartwell, Elevance Health, Eli Lilly & Company, Embecta, Genexa, Haleon, Hikma, Kaleo, Kenvue, Liquid IV, McKesson Medical-Surgical, Novo Nordisk, Pfizer, Sanofi, Teva, Unilever, and Viatris.

Direct Relief also received financial support through other companies and campaigns, including the Bungie Foundation, Humble Bundle, FedEx, Holland America Line, Carnival Cruise Line, Carnival Corporation & plc Foundation, Princess Cruises, Seabourn, and Yardi Systems, among others.

Looking Forward

As the response continues, Direct Relief remains able to provide support as a result of its existing strong relationships with local groups that were already receiving Direct Relief medical product shipments and ongoing work with medical experts with community knowledge around requests.

Each of these groups has an unwavering commitment to their communities – before, during, and in the recovery phase of the wildfires – and Direct Relief will support their work as Maui continues to recover.

In response, Direct Relief immediately mobilized to equip and fund response and recovery efforts, dispatching medical aid, field medic packs, hygiene kits, and requested medications, as well as providing emergency funds for search and rescue operations supporting several groups, including Turkey’s Ministry of Health, metropolitan municipalities and local organizations in both Turkey and Syria.

As the scale of devastation mounted, the extended recovery phase needed strong support as well, and thousands of people continue to live in temporary shelter zones, in tent or container housing, where challenges to health and sanitation access remain.

As the recovery phase moves forward, Direct Relief is focused on physical therapy and rehabilitation services, mobile maternal and child health services, mental health and psychosocial support services, strengthening primary health care, and supporting the well-being of healthcare professionals, including accommodation for those whose homes were destroyed. Shipments of medical aid continue on an as-needed basis with local groups.

In the year since the earthquake, the organization has provided more than $8 million in financial assistance to groups providing essential health services in Turkey and Syria. Direct Relief has also provided 577 tons of medical aid, valued at $133.1 million wholesale, to support the work of health workers in the wake of the earthquakes.

Financial Summary

The information included in this report, by necessity, includes unaudited figures because the organization’s formal audit coincides with its fiscal year, which is from July 1 to June 30. Audited figures for this period will be included when that audit and report are completed. Numbers are as of Dec. 31, 2023.

Who Donated to the Response?

In response to the crisis, Direct Relief received contributions from 55,253 donors totaling $16,657,322 from individuals, foundations, businesses, and organizations located in 111 countries (including the U.S.). Donations from all 50 U.S. states and four territories were received.

Of the total amount of Turkey-Syria earthquake-designated contributions —

• $9,469,680 was contributed by 54,988 individuals
• $5,974,182 was contributed by 141 businesses
• $1,068,000 was contributed by 41 foundations
• $145,460 was contributed by 83 organizations

How Were the Funds Used?

Of the total Turkey-Syria earthquake response-designated cash contributions received to date, Direct Relief has expended or committed $11,877,002 to improve the health and lives of people affected by the disaster.

This includes:

• $6,869,596 on financial assistance to organizations supporting emergency response
• $2,118,763 on transportation (paid and pending)
• $1,729,291 on emergency personnel costs and other organizational response management expenses
• $1,159,352 on procurement of oxygen concentrators, field medic packs, and other supplies

Consistent with Direct Relief’s Donation Policy, 100 percent of funds received for specific emergency events are devoted entirely to those events, and none of the funds donated for Turkey-Syria earthquake response have been used for fundraising.

(As explained here, all Direct Relief's fundraising expenses are paid by the Direct Relief Foundation, which uses earnings on previously received bequests to the organization for this purpose and other non-programmatic costs.)

Medical Material Assistance

Direct Relief’s earthquake response support can be divided into three categories: medical material assistance, direct financial assistance, and information assistance.

Direct Relief’s main objective in any large-scale disaster response is to deliver emergency medical resources safely and securely – requested, approved by the responsible government authority, and appropriate for the circumstances – where they are most needed, as fast and efficiently as possible.

As aftershocks continued, Direct Relief began working with local, regional, and country-level organizations, including Turkey's Ministry of Health, to determine needs and requests for aid.

In Syria, Direct Relief leaned into strong, existing relationships with organizations that have long worked in the country to channel a high volume of aid.

At the start of the emergency, Direct Relief’s first emergency shipment consisted of more than 100 field medic backpacks for search and rescue personnel dealing with injuries, infections, and other acute medical needs. Working with organizations such as the Society of Critical Care Medicine and the Renal Disaster Task Force, Direct Relief supported intensivists working to treat and stabilize those with traumatic injuries.

As needs became clearer, Direct Relief began to channel large volumes of aid via three separate charter flights to the region as part of the response. In April, an 80-ton charter, with transportation provided by FedEx, included specifically requested antibiotics, respiratory medications, anti-seizure therapies, vitamins for children and adults, personal protective equipment, hygiene items, and other needed medical products. FedEx also provided funding for many of the emergency medical backpacks sent.

As of Jan. 31, 2024, Direct Relief’s Turkey-Syria response efforts have resulted in the delivery or pending delivery of 577 tons of medical aid, valued at $133.1 million wholesale, to support the work of health workers in the wake of the earthquakes.

In Turkey

Healthcare facilities and organizations in Turkey that have received medical goods include:

In Depth

With Thousands of Buildings Destroyed by Earthquakes, Containers House Families and Physicians in Turkey

Mothers & Midwives Hope for New Life in Northwest Syria

‘Death Just Beneath You’: Doctor Describes Turkey Earthquake, Ongoing Challenges

In Syria

Healthcare facilities and organizations in Syria that have received medical goods include:

• Syrian American Medical Society
• Syrian Relief and Development
• Independent Doctor's Association

Direct Financial assistance

Thanks to the outpouring of financial support from donors, Direct Relief continues providing cash assistance to help facilities and organizations effectively respond to the ongoing needs of patients impacted by the earthquakes.

To date, Direct Relief has identified, vetted, and awarded emergency financial support totaling $4,694,240 for groups responding to medical needs related to the earthquake. The organization has supported groups in Turkey with $1,530,000 in funding and groups in Syria with $3,164,240.

Financial Support for Response in Turkey

Financial Support for Response in Syria

A top priority of grantmaking in Syria focused on improving the operational capacity of local NGOs in Syria with warehousing improvements, repairing storage damaged by the earthquake, and improving inventory management systems so groups could coordinate aid to northwestern Syria most effectively. Grants also focused on strengthening health services and infrastructure weakened by more than a decade of civil war.

Information Assistance

In addition to providing medical material and financial aid, Direct Relief has been a critical information supplier to key organizations involved in the response. Working with technology companies, academic institutions, and health providers, Direct Relief has used human mobility data, geospatial analysis, and other data collection and analytics instruments to help understand key issues.

Within Turkey, Direct Relief has focused mainly on understanding the scale of human displacement. Using data from Meta on change in population density and movement between places, linked to surveys on the needs of internally displaced persons, Direct Relief has shared nearly two dozen reports and analytical data feeds focused on population displacement with agencies ranging from AFAD to the World Food Program.

Corporate Support

Direct Relief was able to supply a large array of medical material support without the expenditure of donor funds due to the in-kind donations from healthcare manufacturers and distributors, many of which Direct Relief works with on an ongoing basis.

Healthcare company donors responded expansively to requests for their participation. Included among them are the following:

Direct Relief also received financial support through other companies and campaigns, including the Bungie Foundation, FedEx, Humble Bundle, Pubity, TE Connectivity, and Yardi Systems, among others.

With the amount of infrastructure damage and displacement of people still significant one year later, true recovery from the earthquake's damage will likely be decades-long. As this phase continues, Direct Relief remains committed to providing support to strengthen local health systems, as well as focus areas in Turkey and Syria.

Those areas of focus include access to oncology care, maternal health and reproductive health services, rehabilitation, recovery of the primary healthcare system, maintaining the cold chain and power systems at the primary healthcare level, improving the well-being of healthcare providers, and support of medical aid and funding for mobile health units for internally displaced people, including Syrian refugees in Turkey.

Supporting first responders

In the year since the quakes, Direct Relief facilitated several trainings for first responders. At the World Intensive and Critical Care Congress, doctors from Syria and Turkey were invited to Istanbul, Turkey, to be equipped with new skills and professional support as they face emergency situations. Doctors in Turkey from various professional societies, including those from earthquake-affected cities, also attended with Direct Relief’s assistance.

In total, Direct Relief provided funding for 182 doctors, including 29 from northwest Syria and 153 from Turkey, to attend the training, where hundreds of healthcare professionals from various countries gathered. The training focused on emergency and essential critical care, an approach that helps decrease mortality by detecting patients who are critically ill.

Strengthening primary healthcare centers with container housing: 58 primary health centers in Hatay collapsed or were highly damaged (out of service) and are operating inside containers. As the main responsibility to maintain the needed medical equipment remained on primary healthcare doctors who were also EQ-survivors; Direct Relief supported Hatay Medical Chamber and Turkish Medical Association to procure the essential medical equipment needed for these primary health centers. Medical staff who lost housing are also using Direct Relief-funded containers.

Access to reproductive and maternal care, as well as mental health services: In Turkey and Syria, Direct Relief is focused on increasing and supporting maternal and reproductive healthcare services, mobile health services, and sustaining primary care access. Direct Relief has supported HASUDER's women's health and reproductive service unit, which provides health services and screenings, counseling, and personal care and family planning items for people displaced by the earthquake.

Supporting access to psychosocial services for those affected by the earthquake, including health workers, also remains a priority. One example of support includes the Turkish Psychiatric Association, which deploys volunteer psychiatrists to earthquake-impacted areas to provide psychosocial services for survivors and first responders.

As the response continues, Direct Relief remains able to provide support as a result of its existing strong relationships with non-governmental organizations that were already receiving Direct Relief medical product shipments, ongoing work with clinical experts in the field to guide distribution and procurement decisions, existing partnerships and contracts in place to quickly request and receive high-quality medications from pharmaceutical manufacturers and distributors, and a strong track record of shipping large volumes of product, including those requiring cold chain packaging and storage, to difficult-to-access places to reach the most vulnerable patients.

Direct Relief is focusing on these areas for long-term recovery by directing funding and medical product support for the continued strengthening of the health system.

The shipments contained 4.4 million defined daily doses of medication and supplies, including cardiovascular medications, wound care supplies, vitamins and more.

Direct Relief Prepped for California Storms

California has been experiencing storms and floods from back-to-back atmospheric rivers, with the next storm expected to arrive late Saturday and continue into Sunday. The storm is expected to bring moderate to heavy rainfall, potential flash floods, and power outages. The California Governor’s Office of Emergency Services has activated its Business and Utilities Operations Center, of which Direct Relief is a member, and the State Operations Center, to coordinate responses needed across the state.

Direct Relief has offered assistance to CalOES, primary care associations, and safety-net healthcare providers. In addition to Direct Relief’s inventory of medicines, medical supplies, and hygiene items, emergency medical backpacks, hygiene kits, generators, and a pre-packed emergency health kit, containing 200 medicines and supplies for acute and chronic health conditions, are ready for deployment if requested.

Syrian American Medical Society Visits Direct Relief

On Friday, staff from the Syrian American Medical Society, or SAMS, visited Direct Relief’s headquarters in Santa Barbara, California, to discuss further ways to collaborate and share supply chain learnings.

The Syrian American Medical Society, founded in 1998, operates as a professional society in the United States, providing networking, educational, and professional services to medical professionals of Syrian descent. Its charitable arm, SAMS Foundation, established in 2007, focuses on delivering life-saving medical services, revitalizing health systems during crises, and promoting medical education in Syria and neighboring countries. Since 2014, Direct Relief has partnered with this NGO to help meet health needs in the region.

Next week marks the one-year milestone since the 8.3-magnitude earthquake and aftershocks struck Turkey and northwest Syria. Since that time, Direct Relief has provided $46.2 million in medicines and medical supplies to SAMS, which then supplied hospitals in Syria treating thousands of people with crush wounds and other injuries and medical complications caused by the quakes.

Medical Support Reaches Yemen

Yemen has endured more than eight years of protracted political and military conflict, high population growth, chronic food insecurity, and an uncertain political transition. In 2023, 21.6 million people required some form of humanitarian assistance as 80 percent of the country was unable to meet nutrition needs and access basic services.

For the last seven years, Direct Relief has partnered with Yemen Aid, a U.S.-based nonprofit founded by Yemeni-Americans that deliver humanitarian assistance and build a self-reliant Yemen with dignity and opportunity accessible to all.  Late last year, two shipments were successfully delivered to Yemen Aid and subsequently distributed in direct coordination with the Ministry of Public Health and Population to public health facilities across the country with pre-identified needs.

Together, these donations totaled 17 tons, equaling 4,130,638 defined daily doses of medication, including a broad range of cardiovascular drugs, anti-hypertensives, antibiotics, hormonal therapies, and mental health treatments in addition to vitamins, wound dressings, and diagnostic equipment.

Operational Snapshot

WORLDWIDE

Over the last week, Direct Relief shipped more than 2.7 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 510 shipments containing over six tons of medications during the past seven days to organizations, including the following:

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 2,114 shipments to 897 partner organizations in 51 U.S. states and territories and 35 countries.

These shipments contained 27 million defined daily doses of medication totaling 366,282 lbs.

In the News

Understanding the Ongoing Opioid Epidemic – The Kansas City Star

Ahead of Fire Season, Tips on How to Protect Home and Family – California News Service

AHA! Santa Barbara partners with Direct Relief helping teens – KEYT

Aloha and Trust.’ Native Hawaiʻian Health Care’s Response to Maui Fires – Angels in Medicine

In anticipation of the storms, Direct Relief is communicating with local authorities, healthcare facilities, and community organizations to assess needs and deploy resources accordingly. With its broad history of responding to emergencies and natural disasters, the organization is well-equipped to provide medical assistance, including essential medicines, first aid supplies, and other critical items to those affected by the storms.

Supporting Local Emergency Response Agencies

As part of the organization’s ongoing commitment to ensuring proper equipping of local emergency response organizations, Direct Relief, in coordination with the California Office of Emergency Services, has donated multiple emergency response vehicles which are being staged to respond to high-risk areas, including the Ventura County Sheriff’s office’s high-water Lenco Advanced Rescue Medevac vehicle.

The four-wheel-drive truck can traverse water and mud up to four feet deep and is equipped with specialized features designed specifically for water rescues. The vehicle has proven instrumental in navigating flooded terrain and reaching areas inaccessible by traditional vehicles over the past year, having supported emergency response with over a dozen rescues during the Port Hueneme flooding events in December 2023.

Direct Relief will continue to monitor the situation as it progresses over the coming days, and offer support as requested.

Today, an estimated 11.4% of people in India, equal to 101 million people, have Type 1 or Type 2 diabetes, with the latter being far more common. This percentage is similar to the U.S., where an estimated 11.6% of the population is living with diabetes. Jali’s highly-cited 1988 study in the BMJ showed the prevalence of diabetes at 5% in a south India township across all ages. For those between 55 and 64 years old, the figure was 41%.

People diagnosed with Type 1 diabetes, an autoimmune disease caused by different factors, including genetics and some viruses, make little to no insulin, a hormone that regulates blood sugar levels and helps the body convert food into energy. Without taking insulin, it can become fatal, and limited access to supplemental insulin can lead to disabilities. Globally, about 8.4 million people had Type 1 diabetes in 2021, a figure that could double by 2040, according to a Lancet study. It currently has no cure.

Type 2 diabetes generally occurs in people older than 45 years old. Excess body fat and other factors cause blood sugar to be too high due to decreased insulin production and because cells show increased resistance to insulin and take in less sugar. Other types of diabetes, including during pregnancy, exist as well.

Jali said that three major challenges facing diabetes care in India are population size, awareness, and access to healthcare. The number of patients across the subcontinent presents policymakers and doctors with several issues. India has 28 states and eight union territories, each with diverse local cultures, languages, and foods. This impedes the standardization of policies to address diabetes care since what might work in one area might not be relevant elsewhere, Jali said.

In terms of awareness, Jali said the situation has improved over the last two decades as a result of dedicated campaigns such as World Diabetes Day. But, he said, the campaigns have been less effective in some rural communities, which still lack knowledge about the disease and the importance of seeking care to help manage it.

However, even with education, people in rural areas also face some of the greatest access-related obstacles. Jali pointed out that rural access is limited due to various factors, including lack of facilities. He is optimistic that government programs, notably the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke, will help address these disparities.

Across many sectors of India, from rural to urban, medicine affordability remains a challenge for many patients and their families, especially if a patient is working through multiple chronic diseases.

Insulin Finds a Way

Seeking to support children and youth who have Type 1 diabetes, Life for a Child, a nonprofit focused on increasing access to insulin worldwide, currently serves over 50,000 children and youth in 48 countries. The group, based in Australia, estimates that there are more children and youth living with Type 1 diabetes in India than in any other country. Four hundred thousand children and youth are estimated to lack sufficient access to insulin and other aspects of care, with at least 50% of these in India.

The nonprofit anticipates an increase in the number of beneficiaries to 15,000 by the end of this year, with a long-term goal of reaching 90,000 people by 2030. Globally, Life for a Child’s goal is to support around 150,000 people with Type 1 diabetes in 65 countries by 2030.

A major challenge related to insulin is that it must be shipped and stored cold, between a temperature range of 2 degrees and 8 degrees Celsius. This challenge can prevent access to insulin in places without reliable power or refrigeration facilities. Delays related to importation and logistics can further complicate shipments.

Faced with these challenges in India, Direct Relief looked to examples in other countries that could provide insights regarding the successful import and distribution of insulin to multiple locations in-country. Pakistan and Sri Lanka provided such examples. Both nations also have a substantial need for charitable insulin shipments and necessitated a decentralized distribution model since no single group, hospital, or government agency could serve as a central hub.  

Using lessons learned with Life for a Child in those two countries, last August, Direct Relief was approved by India’s Ministry of Health to send 80,000 insulin cartridges, enough to support 5,630 youths, to 15 healthcare facilities across 12 cities in India, including Dr. Jali’s facility and others in Ahmedabad, Aurangabad, Bangalore, Belgaum, Coimbatore, Kota, Nagpur, Navapur, Pune, Srinagar, Trivandrum, and Vellore. This shipment was followed in October by the delivery of 16 single and double-door pharmaceutical-grade refrigerators to ensure the safe storage of insulin as part of Direct Relief’s Global Cold Chain Initiative.

The successful game plan to ship this amount of insulin involved the combined efforts of Direct Relief, its contracted warehouse in the Netherlands, and various freight forwarders, which together have been acting as the “hub.” A single entity in India, Samatvam, applies for and receives all importation permits and tax exemption documentation. Direct Relief and its freight forwarders then work to have the shipment imported, cleared, and delivered safely to each individual dispensing facility.

In combination with these programs, Jali said insulin pens, especially in rural areas, can also present a type of solution since they do not need to be refrigerated after they are opened and are good for about one month.

Winning the Race

Assessing current trends, Jali said that while prevailing social factors, like preserved foods and more sedentary lifestyles, might be leading to an increase in the number of patients diagnosed with Type 2 diabetes, other tools can help address the disease, even as programs focused on outreach, education, and the encouragement of lifestyle changes are ongoing.

A major development, Jali said, is the vastly increased speed by which a person can check their blood sugar. He recalled receiving results in the early 1980s took about one day. Now, results are instantaneous, and some solutions, which are still quite expensive, offer a constant reading.

Jali also said that personalized treatment plans based on precision medicine are emerging. He estimated that in five years, he and his colleagues will have a genomic lab that will allow them to tailor care to individuals based on their genes.

While high-tech options are emerging, a major help in recent years when it comes to patient care is a simple text message. “By sending them messages or calling via mobile to remind and encourage them to attend appointments, they reciprocate positively and see that we care for them,” he said. Recognizing the importance of making patients feel comfortable and increasing the chances of patients engaging with the hospital, it offers yoga and other traditional programs.

Another way Jali and his team care for patients, specifically younger ones, is via a free summer camp the hospital organizes with support from Life for a Child, Direct Relief and the EU. The camp, which mostly includes children from rural areas, enables screenings, education, and strategies to help people delay the onset of Type 2 diabetes. Besides health factors, Jali noted that the financial aspect of diabetes “can put a lot of pressure on a nuclear family.” The team also goes to local schools to do diabetes screenings.

Beyond these health-based initiatives, Jali said the fight against diabetes also requires other tactics. Penpals United was a successful program he referenced, which helps connect kids living with Type 1 diabetes worldwide via video-based support groups. He also said it’s important to tell kids and parents about people who have been successful despite having diabetes, from becoming doctors to running ultra marathons and winning medals.

“We want to empower children from the beginning,” he said. “So they understand they’re not alone in society and that others with diabetes can achieve.”

Direct Relief has provided insulin, diabetes management products, and cold-chain refrigeration for temperature-sensitive therapies to support children and young people through Life for a Child in 44 countries, including India.

Additional reporting was contributed by Kelsey Grodzovsky.

The shipments contained 3.2 million defined daily doses of medication and supplies, including diabetes medications, wound care supplies, nutritional supplements, and more.

Amputees receive free prostheses in Ukraine

Earlier this week, the Danish organization Levitate hosted a prosthetics sports event along with Unbroken Rehabilitaion Center (both partner organizations of Direct Relief). Levitate specializes in creating prosthetics sports gear that’s affordable, durable, and easy to use; and now Levitate will be able to help Ukrainian amputees get on their feet.

With funding from Direct Relief, their team will supply running blades and other prostheses to patients at the country’s largest rehabilitation centers, Unbroken and Superhumans, as well as other partners identified throughout the program. The Levitate team will also personally do the training, fitting, and adjusting of prosthetics for the patients in Ukraine.

The founder of Levitate, Lasse Madsen, is an amputee himself and had to overcome a considerable series of financial and emotional hurdles to get the gear he needed, including time-consuming appointments and costly equipment that often failed to deliver on quality. He and his team are determined to make the process easier for others.

Mountain Heart Nepal Receives Medical Products from Direct Relief

Native Hawai’ian health care continues to respond to Maui fires

The Maui wildfires last August, which claimed the lives of 100 people, presented a series of tragic circumstances. However, healthcare professionals with deep roots in the community, none of whom had emergency response experience, refused to be deterred and responded to the specific needs of their patients. And they did so in a way that reflects the benefits of building trust and familiarity with the local culture.

“We know Hawaiʻians. Even if it’s free, no one is going to come in and just take. That’s not our style. If we have nothing to contribute, we’re not going to take,” said Mālia Purdy, executive director of Hui No Ke Ola Pono, one of five Native Hawaiʻian healthcare systems.

Read the full story here.

OPERATIONAL SNAPSHOT

WORLDWIDE

Over the last week, Direct Relief shipped more than 940,000 defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 535 shipments containing over nine tons of medications during the past seven days to organizations, including the following:

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 1,588 shipments to 771 partner organizations in 51 U.S. states and territories and 29 countries.

These shipments contained 98.2M defined daily doses of medication totaling 320,619 lbs.

The Maui wildfires last August, which claimed the lives of 100 people, presented a series of tragic circumstances. However, healthcare professionals with deep roots in the community, none of whom had emergency response experience, refused to be deterred and responded to the specific needs of their patients. And they did so in a way that reflects the benefits of building trust and familiarity with the local culture.

“We know Hawaiʻians. Even if it’s free, no one is going to come in and just take. That’s not our style. If we have nothing to contribute, we’re not going to take,” said Mālia Purdy, executive director of Hui No Ke Ola Pono, one of five Native Hawaiʻian healthcare systems.

Purdy, a Native Hawaiʻian, said that setting up a way to get aid to the folks who needed it most was just one part of her organization’s successful response. Immediately after the shelter at War Memorial Complex was established, staff members were there daily, despite Purdy telling them they could take time off to address the losses so many of them suffered.

“I told them (staff) to stay home. They came in anyway,” Purdy said.

All of their post-fire work was done in direct response to community needs – something they could determine due to the trust so many people had in them.

“It was our first natural disaster, so we were just trying to learn the protocol, what services were expected and if we could contribute to what was going on,” Purdy said.

Staff at Hui No Ke Ola Pono’s neighboring Mauliola pharmacy at Wailuku’s Cameron Center were working through the same questions as they were responding at War Memorial and beyond. Hui No Ke Ola Pono and Mauliola had created partnerships in the past, mostly around health education related to diabetes, hypertension, blood pressure monitoring, and smoking cessation. Hui No Ke Ola Pono also referred many of their patients to Mauliola, which has a nonprofit arm.

Like Hui No Ke Ola Pono, Mauliola Pharmacy staff had a bias for action after the fires and began sourcing and filling prescriptions on the day the War Memorial shelter opened. The two groups communicated needs as they responded to survivors and those hosting them in other parts of the island.

“We were trying to organize the chaos as much as possible,” said Tori Ching, director of operations at Mauliola Pharmacy. The pharmacy saw prescriptions jump from about 800 per day to 2,000 per day in the days after the fires.

Like Purdy and her team, Ching and her colleagues created systems on the fly to respond as quickly as possible while integrating new information and optimizing the response.

Once people were let back into Lahaina, Ching and her colleagues began going door-to-door in order to make sure residents had their medications, something she said might not have been at the top of their to-do lists after having lost their homes and, in some cases, loved ones.

The opportunity to help people in this way, Ching said, was based on trust that had been developed over the years.

“Working with patients who already have that trust, it helped us with accessibility,” she said.

“The number one thing when being in a smaller community or working with Native Hawaiʻian populations, our culture here is really based on Aloha and trust.”

Lomilomi and Ho’oponopono

Before the fires and after, Hui No Ke Ola Pono and Mauliola both strived to bridge the gap between traditional Hawaiʻian medicine, called Lāʻau lapaʻau, and Western medicine. Programming at Hui No Ke Ola Pono is built on foundational Native Hawaiʻian customs, beliefs, and practices, according to Purdy.

While Hui No Ke Ola Pono provides primary care, dentistry, behavioral healthcare, and cardiac rehabilitation, they also offer and train practitioners to offer Lomilomi and Ho’oponopono, Native Hawaiʻian healing services. Purdy described Lomilomi as “massage-like, but not nearly as relaxing, it’s more painful… you’re trying to work something out. It’s a practice to realign your body and bring your spirit back into you so you are in total alignment.”

Ho’oponopono, she said, is more “family-based conflict resolution. It’s family therapy but not family therapy.”

Offering them gives the clinic a chance to bring in patients who might not feel comfortable going to Western medicine-based clinics, Purdy said. And vice versa.

“Our native Hawaiʻian population has kind of a reputation for being untrusting of the Western medical system and so it’s important for us to provide access to other forms of healing. And on the island of Maui, we are the only health center that has linkages and ties to traditional healing practitioners.”

Mauliola Pharmacy also fulfills the role of providing a bridge between traditional and Western care. In June, the pharmacy purchased land with the intention of planting traditional crops and providing a resource for community members to reconnect with the land.

From Survival Mode to Rebirth

More than five months after the fires, Purdy and Ching said housing remains a major challenge for survivors on the island. Ching said many pharmacy patients are in “survival mode” as they are focused on finding and maintaining long-term housing.

Given this, she said it’s been hard for her and her colleagues to get patients to focus on things like monitoring their chronic conditions, even as pharmacy staff understand it’s not the priority for patients now.

“We are trying to provide services for the community that they actually need. So we want to come in with a level of awareness. We also want to get back to that place where we can make things like getting them to check their blood pressure a priority again,” Ching said.

Like many other nonprofits, Purdy said that her organization is in a long-term planning period, especially since many outside organizations are starting to offer less support. The overall goal, she said, is training and equipping people and teams that “plan to be on Maui forever.” A major focus has been mental health care and finding ways to bring in more resources.

One plan that has already been manifested is the new Lahaina Comprehensive Health Center. A partnership between Hui No Ke Ola Pono, Hawaiʻi’s Department of Health, Mālama I Ke Ola Health Center, Waiʻanae Coast Comprehensive Health Center, Hawaiʻi Island Community Health Center, and Mauliola Pharmacy, it offers all survivors a venue where they can receive treatment including primary care, wound care, dentistry, podiatry, behavioral care, and case management. As part of the initiative, volunteers and staffers go into the community to share information regarding available resources and check in on survivors.

As new health-related initiatives emerge, Purdy hopes that locals will also be a focus and play a leading role in rebuilding efforts more broadly, something she said should be less about optimizing for tourism and more on “the ways we care for the land, which holds a lot of historical significance,” she said.

Direct Relief has provided medical aid to Hui No Ke Ola Pono and Mauliola pharmacy, and financial aid to Hui No Ke Ola Pono, in response to Maui wildfires.

The shipments contained 3.2 million defined daily doses of medication and supplies, including insulin, surgical supplies, nutritional supplements, and more.

Medical Aid Supports U.S. Health Clinics

In response to recent severe storms, this week 12 pallets of requested medical aid departed Direct Relief’s warehouse in Santa Barbara, California, for U.S. health clinics across the country.

The medical aid includes pain medications, diabetes treatment supplies, and vitamins, which are essential for providing continued care to patients. These donations will help ensure continued care amid weather disruptions across the country.

Equipping Search and Rescue Teams in Puerto Rico

This week, Direct Relief donated 24 field medic packs to the Puerto Rico Emergency Management Bureau and Disaster Administration’s (NMEAD) specialized rescue units, as well as Puerto Rico’s Urban Search and Rescue Medical Team.

Other attendees included the search and rescue coordinators’ unit composed of doctors, nurses and paramedics who are charged with managing and executing rescue operations, ensuring efficiency across the search and the safety of the teams.

Direct Relief’s field medic packs contain supplies and equipment to meet a variety of prevalent disaster-related medical issues, including infection control, diagnostics, trauma care, and personal protective equipment.

Respiratory Medications Reach Newborns in Lebanon

A shipment of lifesaving medications for premature infants recently arrived in Lebanon, and will support hospital care in NICU settings. The requested respiratory medications, donated by Direct Relief, are otherwise unavailable in Lebanon due to medication stock-outs from the country’s economic crisis.

The medications were delivered to Lebanon in coordination with NGO Anera, and are being used to improve lung capacity for babies requiring breathing support.

OPERATIONAL SNAPSHOT

WORLDWIDE

Over the last week, Direct Relief shipped 1.8 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 354 shipments containing over seven tons of medications during the past seven days to organizations, including the following:

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 1,024 shipments to 606 partner organizations in 51 U.S. states and territories and 22 countries.

These shipments contained 19.2M defined daily doses of medication totaling 281,455 lbs.

The population has braced for more of the same as the mercury fell to the current level of around 27 degrees Fahrenheit (-3 Celsius).

The recent holiday season in Ukraine was also overshadowed by massive Russian missile and drone attacks on cities across the country. But almost two years into the war, Direct Relief’s local partners are redoubling efforts to bring quality healthcare to the population despite power interruptions and missile attacks.

“We went through a complete blackout, we were cut off when the biggest mobile operator was hacked, but we only became stronger and more resilient,” said Yuliia Dmitrova, head of the TAPS foundation in Dnipro, one of the country’s hardest hit cities.

As well as distributing medicines to hospitals and providing dental and other services, the organization will again this year hold healing retreats for the children and widows of those lost to the fighting.

Among Direct Relief’s core partners and other NGOs receiving support, 2023 produced a broad springboard of initiatives with long-term application: prosthetics production, fitting and rehabilitation; psychosocial services for war-affected citizens; mobile health clinics for children in rural communities, and many more initiatives that will be carried over into 2024.

This was in addition to supplying medical products. Last August marked $1 billion of these delivered since the war’s start in February 2022 through Direct Relief’s partners to the people of Ukraine in the largest humanitarian aid response in the organization’s 75-year history.

Now totaling more than $1.1 billion, these resources have been invaluable in supporting the country’s healthcare system in the darkest times.

There Will Be Light – and Operations

“We know that this winter will be worse than the last,” said Katya, a specialist working with a DR-supported psychological care project in the Kyiv suburb of Bucha. “The other night, we were attacked with 70 drones, and Russia will have elections,” she said after the first big attack in late November and referring to President Vladimir Putin’s predicted fifth-term victory in March. “We are getting ready.”’

Among other measures, Ukrainian technicians have been fitting health facilities with Tesla Powerwalls donated in Summer 2023 by the Polish government and delivered with logistical support from Direct Relief and its Kharkiv-based partner Charity Fund Yevhen Pyvovarov.

The 508 units – rechargeable 14 kWh lithium-ion batteries that can provide power during peak times, power outages, and at night – will work in several regions along the 620-mile (almost 1000-km) frontline. Direct Relief is now working with the Ukrainian government on further steps to keep hospitals and clinics running.

Smaller civil society initiatives also aim to fill gaps in Ukraine’s preparations this winter. One is a project by Mission Kharkiv, an NGO that primarily distributes cancer medicines for Direct Relief, to provide first aid training and blast-proof medical kits for thousands of workers at the country’s power plants.

Most had no such training during decades on the job, so a 90-minute course recently delivered to workers at a plant in the eastern city of Kharkiv was entirely new for them. Realistically, they may retain only 50% of the skills demonstrated, said trainer Darya, a lawyer at a Ukrainian bank, but this can still make a difference in a crisis.

Darya decided to qualify as a first aid trainer so she could make a personal contribution to the war effort in her spare time: “I wanted to help people in Kharkiv to learn to do things like apply a tourniquet and be able to save lives.”

There is palpable fatigue among people you meet on the streets these days, but the spirit of volunteering is still strong across Ukraine. This was apparent on the International Volunteer Day on December 5. In Kyiv, more than 5,000 people visited an exhibition venue for diverse talks, awards and displays by dozens of NGOs from all fields of activity.

Ukrainian President Volodymyr Zelensky separately honored this contingent of society as “another strength of ours, our guard of those who care, our army of active Ukrainians.”

No one is slacking off – there is simply too much to lose after the trials and gains of recent months.

“Despite ongoing challenges, the humanitarian sector in Ukraine remains resilient and demonstrating unwavering commitment,” said Anton Gulidin, an advisor to Ukraine’s ombudsman for human rights and the head of NGO Friends of Ukraine Foundation, which had a stand at the event. “The sector continues to innovate, develop new projects and sustain its momentum.

The next morning, on the ‘new’ St. Nicholas’ Day – Ukraine last year moved its Christmas holidays to Western dates in a permanent break with the Russian Orthodox church – a blue-clad Ukrainian Santa visited young patients at the Okhmatdyt National Children’s Specialized Hospital in Kyiv.

The day brought surprises for children and adults alike: “I checked my mail and received good news [about] our project for mobile pediatric services for children,” said Marina Makarenko, the head of Direct Relief’s partner Charity Fund Modern Village and Town, or CFMVT. She had stopped by the event at the hospital to add some donated gifts to the pile.

The mobile clinic project, implemented last year by CFMVT together with Okhmatdyt, is being further funded by Direct Relief starting in January, ensuring that expert medical care reaches children in rural communities across a wider area of Ukraine – regardless of the weather.

The shipments contained 14.9 million defined daily doses of medication and supplies, including children’s vitamins, diabetes treatments and glucose monitoring supplies, vaccines, nutritional supplements, anti-inflammatories, and more.

Supporting Mobile Clinics In Nepal, Post-Earthquake

This past November, a 5.7-magnitude earthquake struck western Nepal, killing 153 people and injuring hundreds more. In this remote area of the country, patients face difficulties accessing medical care even in ordinary circumstances and are particularly medically vulnerable in emergency situations.

Mountain Heart Nepal, a Nepali non-profit that specializes in providing emergency medical care, quickly moved into action. With grant funding from Direct Relief and equipped with field medic packs provided by FedEx, their teams set up four mobile clinics, reaching over 700 patients in the highly earthquake-affected districts of West Rukum and Jajarkot.

These clinics provided immediate care for the injured but also performed general health screenings, dental care, infectious disease treatment, and supplied medication refills for the management of chronic diseases, including hypertension and diabetes.

Equipping Search and Rescue Teams in Mexico

This week, the Mexican Secretariat of National Defense (SEDENA) received thirty field medic packs funded by FedEx and three emergency health kits, all donated by Direct Relief. The donations contain critical medical supplies that will support Mexico’s future search and rescue operations.

Increasing support for tuberculosis care in Syria

Compounding humanitarian crises of protracted civil war and catastrophic earthquakes last February have significantly weakened the overall healthcare system in northwest Syria. Earlier this year, Syria Relief and Development, a local NGO and long-time partner of Direct Relief, was working to sustain the operations of the tuberculosis treatment center in the Azaz region.

As the sole operational TB facility within an area housing over one million people, this treatment center plays a vital role in preventing the spread of tuberculosis while also alleviating the suffering and reducing deaths associated with the disease.

To help address this pressing healthcare need, Direct Relief provided grant funding to help sustain the operations of the center. In total, 456 patients were helped with services, including TB investigations and the provision of TB treatment drugs.

OPERATIONAL SNAPSHOT

WORLDWIDE

Over the last week, Direct Relief shipped 13.1 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 369 shipments containing over seven tons of medications during the past seven days to organizations, including the following:

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 655 shipments to 452 partner organizations in 47 U.S. states and territories and 12 countries.

These shipments contained 11.2M defined daily doses of medication totaling 142,966 lbs.

Several tornadoes were reported in Florida’s Panhandle on Tuesday morning, including in the Panama City area, and more than a dozen counties were under tornado warning conditions as the storm moved eastward.

Snow and icy conditions had swept through many areas of the Midwest and Plains regions, with some recording blizzard conditions. Heavy rains and high winds were also present in many areas of the U.S, including the Northeast, prompting flash flood warnings.

Health needs during extreme weather can vary, from risks of hypothermia due to extreme temperature swings to health risks associated with power outages. Evacuations and displacement from tornadoes and other storms can bring risks if evacuees are without medications to manage chronic conditions for extended amounts of time.

Direct Relief is in communication with health centers, free clinics, primary care associations and other organizations about potential needs and maintains an emergency stockpile of essential medicines often requested.

The organization is ready to respond to requests as needed.

According to Santa Barbara County Fire Captain Safechuck, a major reason for the reduced death tolls over the past three years is that wildfires have stayed away from urban areas. But hoping that fires will continue to burn away from population centers is not a strategy Safechuck and his colleagues would like to rely on.

“We are constantly trying to push out information on how people in the community can stay safe,” said Safechuck, a 23-year veteran of the department. “They need to be paying attention prior to a fire happening, particularly when the conditions are right for a fast-moving fire, and have an action plan including for when kids are at school, if some family members are not ambulatory, if someone’s out of town, or other circumstances.”

Trying to instill residents in Santa Barbara with a sense of personal responsibility when it comes to wildfire safety is a key firefighting tactic of the Santa Barbara County Fire Department Fire, even as they have increased their firefighting capabilities through new technology and equipment. Still, it’s not possible for any firefighting department to immediately respond to all areas under attack during a large-scale event.

“Most people believe there is going to be a fire engine at their house during a wildfire. Eventually, that will be the case, but it takes time for us to build that system. We have to use our mutual aid system to get resources from the state. It might take days. Our crew will work as hard as they can to save the community, but it just takes time,” Safechuck said.

Safechuck also stressed the realities of being in the danger zone, further reinforcing the importance of creating an action plan ahead of a fire event.

“It’s hard for people to imagine what it is like in that (wildfire) environment. People think they’ll defend their homes with a garden hose… but it’s so hot, every breath you take is very heated, your eyes water, and you start to vomit; it’s very hard for trained professionals to operate in that environment, so compare that to someone who has not been trained, doesn’t have the right gear on, and has a limited water supply,” he said. “It’s very dangerous for them.”

Ultimately, the goals of wildfire preparations for residents are two-fold: both to create a defensible space around houses and to be able to evacuate safely if a wildfire is threatening. Both steps can play a significant role in helping local firefighters do their jobs.

“The sooner people evacuate, the roads become more freed up for firefighting vehicles. If people don’t take it (evacuation orders) seriously, they can become trapped in there, and it makes it harder for us to operate to attack the fire. If they become trapped, our priorities change. Life safety is a priority for us but it takes away from efforts of putting out the fire. If you don’t feel safe, or you’re not sure, evacuate as long as you have a route out of there,” he said.

A central aspect of the department’s public outreach strategy is the Ready, Set, Go Action Plan developed in collaboration with the U.S. Forest Service, CalFire, and several other Southern California fire departments. Ready. Set, Go is a 10-page booklet that educates residents on how to prepare for wildfires so that they have the best chance of defending their homes and saving their own lives through proactive decision-making.  

Some of the tactics include how to create a defensible space around a house, how to build a more fire-resistant house, how to prepare a house when it’s threatened by fire (for example, by closing exterior vents), an action plan guide, what to include in a to-go kit, and a checklist for what to do as a fire approaches.

Firehawks, AI, and more

In addition to a focus on public outreach, the Santa Barbara County Fire Department has been bolstered in recent years by advanced warning technology and aerial support. There are now almost a dozen remote weather stations placed around the county, including nine permanent units and two portable ones. Additionally, the county has one AI camera system, constantly scanning high-risk areas for smoke. Santa Barbara is also part of a statewide camera system that helps identify brewing wildfires.

Once a wildfire begins, the county can utilize its Firehawk helicopter, a converted U.S. Air National Guard MH-60 Pave Hawk optimized for firefighting with an external water tank, rescue hoist, improved avionics and the ability to travel about 30% faster than the department’s other aircraft, allowing it to get back to the fire area more quickly. The county’s Firehawk helicopter was previously used during two combat tours in Afghanistan. Purchased in 2019, with support from Direct Relief totaling over $1.1 million, the Firehawk has the ability to drop about 1,000 gallons of water, which is more than three times the capacity of a Huey, a smaller and older helicopter which is also part of the county’s firefighting arsenal.

Since 2022, the helicopter has dropped about 182,700 gallons of water on 37 wildfires. Last year, the Firehawk, which is often the first responder on the scene of fire and medical emergencies, accounted for almost 90% of all water dropped by Santa Barbara County Fire Department’s Air Support Unit. It has also been involved with five rescues on the Channel Islands, seven hoist rescues, and five medical evacuations.

But even with these tools, Safechuck said recent wildfire fatalities speak to the need for residents to stay vigilant and prepared.

“We are better at fighting fires than we’ve ever been in the past, and yet we’re still having fires that are taking the lives of a lot of people,” he said, noting that wildfires have recently occurred in areas that have not experienced them historically.

“As the population grows in more rural areas, everything is growing more laterally and pushing more into more urban interfaces. During fires in those areas in the past, maybe there were only a few homes, but now there are many more. It’s important that communities like those get up to speed so that they’re as prepared as possible,” he said.

The shipments contained 24 million defined daily doses of medication and supplies, including prenatal vitamins, vaccines, nutritional supplements, anti-inflammatories, and more.

Puerto Rico Health Fair

Recently, Direct Relief and Puerto Rican NGO La Fondita de Jesús collaborated to bring primary healthcare services to the community of Villa Calma in Tao Baja, an underserved metropolitan area composed of roughly 150 families in Puerto Rico vulnerable to flooding.

Volunteer healthcare providers from La Fondita de Jesús treated community members using a mobile medical unit donated by Direct Relief. Services included administering vaccines and visiting patients with mobility challenges to ensure they were cared for. Direct Relief team members distributed personal care items and solar-powered lights for use since the community experiences frequent power outages.

Additionally, as part of La Fondita de Jesús’ mission to empower communities on self-sustainability, the organization delivered groceries to families and provided community development education, including maintaining home gardens.

Providing Medical Oxygen in Yemen

An oxygen plant opened this week in Yemen’s Shabwah Governorate, bringing medical-grade oxygen to nearly 70,000 individuals being treated in the region’s hospitals and health centers. This project was installed and facilitated by Yemen Aid with funding from Direct Relief and will produce up to 50 cylinders of oxygen per day.

The World Health Organization classifies medical oxygen as an essential medicine and is often used in healthcare settings to treat patients with respiratory illnesses, like Covid-19 and pneumonia, during surgery and trauma care, in the neonatal intensive care unit for babies requiring additional oxygen support, and more.

OPERATIONAL SNAPSHOT

WORLDWIDE

Over the last week, Direct Relief shipped 22.1 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 528 shipments containing over three tons of medications during the past seven days to organizations, including the following:

YEAR TO DATE

Since January 1, 2024, Direct Relief has delivered 344 shipments to 276 partner organizations in 42 US states and territories and 10 countries.

These shipments contained 11.2M defined daily doses of medication totaling 142,966 lbs.

After a March 2023 tornado leveled a health center in Mississippi, the organization was able to run operations via a resilient power microgrid system for the better part of a year and continue serving patients, many of whom had lost everything.

The state’s oldest federally qualified health center was struck by an EF4 tornado that swept through the state last year, killing over 20 people and injuring many more. Delta Health Center’s Rolling Fork location was destroyed by the high winds, and the group swiftly established a temporary clinic to make sure residents could continue receiving care.

Since then, the community has continued to recover from the storm, and Delta Health Center has worked alongside affected residents nonstop. The health center’s staff have gone door-to-door to provide access to care, participated in community partnerships to provide food and daily necessities, and maintained a presence in their original location.

Operating there with power was made possible by the Footprint Project, a nonprofit that provides clean energy to communities after climate-related disasters. Delta Health Center had renewable energy just three days after the storm through the beginning of November 2023. The health center was provided with a Tesla microgrid that supplied four kilowatts of solar power energy with up to 30 storage hours at a time. The Footprint Project also provided a portable solar generator and eight solar backpacks to support home health care.

“It was probably one of the longest microgrid deployments that we’ve done for a disaster,” said Will Heegaard, operations director at Footprint Project, who traveled to Mississippi after the storm to install the system.

Adoris Turner, deputy chief executive officer at DHC, said the solar power allowed the health center to offer services through the worst phases of Rolling Fork’s recovery.

“It was a lifesaver, and I literally mean a medical lifesaver,” said Turner. “The ability to see a patient who may be having an asthmatic crisis or people who are having any type of medical need, it went a long way to have our facility up and running.”

Rolling Fork is a small city with a geographic footprint of less than two miles within Sharkey County in Mississippi’s Delta. Prior to the storm, about 2,100 residents lived in the area, and half of the housing structures were renter-occupied. On March 26, President Biden declared a major disaster in Mississippi, providing a pathway for assistance in Carroll, Humphreys, Monroe, and Sharkey Counties, according to FEMA.

“It’s a really slow process,” said Temika Simmons, DHC’s Chief Public Affairs Officer. “There’s a lot of cameras, there’s a lot of assistance, and then after a few months, there’s just so many people who have left Rolling Fork.”

According to the Federal Emergency Management Association, 442 homes were affected by the tornado, with 130 completely destroyed. Less than half of the residences were insured.

Related Content: Someone to Talk To: Health Center Provides Support After Devastating Tornado

Many residents remain displaced, and some have found comfort in neighbors’ and family member’s homes. Health center staff say they have prioritized making daily necessities and accessible healthcare the highest priorities, given so many residents have yet to return to a sense of normalcy.

“If you lost everything — like you don’t even have a toothbrush, and you are still sleeping in grandma’s living room while driving your kids to a different city for school — what does that look and feel like?” Simmons asked. “You’re alive; you’re still living somewhere, but you’re not at home. So we’re thinking about ‘what do people need to feel like they are at home and get back to their normal routine?’”

Simmons said that households are still without running water, electricity, and internet service. She said that Mississippi is a transient community in that people often drive to other cities for work from where they live, making it more difficult to provide care simply based on location.

Before the solar microgrid arrived, Delta Health Center used two gas generators to operate a temporary clinic and a small tent in the health center’s parking lot. After the initial installation of the microgrid, Heegaard said that the health center staff were able to operate the solar energy source themselves.

“That entire clinic, when we were on site two or three days after the tornado, that thing was not habitable. The whole hangar was a doublewide mobile office…it was cracked, split apart by the force of the wind (of the) tornado. So you definitely couldn’t go inside, the whole facility was unusable,” he said.

The microgrid and the backpacks allowed health center staff to treat Rolling Fork patients in their hometown as well as wherever residents were calling home. The health center has 12 locations across Mississippi and six school-based care sites, according to its website. Rolling Fork residents were allowed to visit any DHC location free of charge during the recovery period.

Heegaard said that the health center used solar energy almost every day, except on severely cloudy days when there wasn’t enough back-up power. Solar energy decreased carbon emissions that contribute to localized air pollution and decreased costs for health centers, which would have purchased several gallons of gas per day to maintain the traditional generators. Heegaard said the solar microgrids are also quieter than gas generators, which supports a better atmosphere to provide medical care.

“It’s not ideal to have a bunch of loud, noisy, smelly generator units running while you’re trying to comfort people,” he said.

The health center is now using a temporary clinic through FEMA that has access to power, so the solar energy system is no longer needed. A new, permanent site will open soon, and staff will continue to offer the same health services to the community, whether they have insurance or not. The staff says that DHC remains committed to the Rolling Fork area, even though it’s unclear how many displaced residents will return to the town.

FEMA has approved $13 million for total individual and household dollars for individual assistance and over $34 million in public assistance. However, Turner says residents still need money for basic necessities. Air mattresses, toothbrushes, fresh produce, and clothing remain top requests in the area.

Direct Relief supported Delta Health Center with medical aid and financial support after the tornado, and also financially supported the Footprint Project’s microgrid installation for the clinic’s continued operations.

The shipments contained 578.9 million defined daily doses of medication and supplies, including antibiotics, prenatal vitamins, personal care kits for those displaced by disasters and emergencies, vaccines, cancer treatment therapies, insulin, and more.

2023 at a Glance

Direct Relief responded to a range of events in 2023, from natural disasters to war. The organization worked with countless health providers and community members who stepped up to help others around them. Below are some of their stories.

Supporting Local Search and Rescue

In 2023, Direct Relief, in coordination with the California Office of Emergency Services, donated multiple emergency response vehicles to bolster search and rescue efforts in California.

Southern California, where Direct Relief’s headquarters is located, experienced torrential rain last week, with some areas receiving over 15 inches.

During these rains, the Ventura County Sheriff’s Office conducted its first in-county deployment of the Medcat, a rescue vehicle donated by Direct Relief earlier this year. The vehicle assisted in the evacuation of seven residents and 10 animals as floodwaters rose.

In addition to the Medcat, Direct Relief also donated a search and rescue truck to Santa Barbara County in July to support local rescue efforts.

OPERATIONAL SNAPSHOT

WORLDWIDE

In 2023, Direct Relief shipped 492 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past year included:

UNITED STATES

Direct Relief delivered 20,600 shipments containing over 407 tons of medications over the past year to organizations, including the following:

IN THE NEWS

‘The Bell’ Symphony for Cello and Orchestra to support Direct Relief efforts in Ukraine – The Strad

Ask Amy: Annual charity column shows ways to give – The Washington Post

US trust to establish new infectious disease hubs in Aurangabad, Latur – The Times of India

The shipments contained 10.3 million defined daily doses of medication and supplies, including insulin, vaccines, emergency hygiene kits, and personal care products.

Hurricane Otis response continues

In response to Hurricane Otis, shipments of Sanofi insulin and hexavalent vaccine products donated by Direct Relief were delivered to impacted regions in Mexico. The shipment of vaccines was received by the Guerrero Ministry of Health at Hospital Raymundo Abarca Alarcón in Chilpancingo. The donated shipment of insulin was received by Federación Mexicana de Diabetes at Hospital Naval in Acapulco.

midwives address health needs in morocco

Since the devastating magnitude 6.8 earthquake that shook Morocco in September, AMSF (L’Asociation Marocaine de Sages femmes or the Moroccan Midwives Association) has been hard at work providing healthcare to women in the localities affected by the quake.

With grant funding from Direct Relief, the non-profit has launched a health caravan, essentially a clinic on wheels, that is providing sexual and reproductive health care and psychological support. Their team is also now able to undertake a preparedness and recovery training in reproductive health via a distance learning module provided by the Women’s Refugee Commission.

OPERATIONAL SNAPSHOT

WORLDWIDE

This week, Direct Relief shipped 9.2 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 503 shipments containing over 10 tons of medications over the past week to organizations, including the following:

YEAR-TO-DATE (GLOBAL)

Since January 1, 2023, Direct Relief has delivered 21,600 shipments to 2,568 healthcare providers in 55 U.S. states and territories and 88 countries.

These shipments contained 549.2 million defined daily doses of medication valued at $2 billion (wholesale), totaling 6.2 million lbs.

IN THE NEWS

Last-minute distribution helps provide toys, hygiene kits, blankets to 100+ Santa Maria families – KSBY

‘The Bell’ Symphony for Cello and Orchestra to support Direct Relief efforts in Ukraine – The Strad

Nourishing Brands: How Liquid IV Became A Billion Dollar Hydra – The Marketing Sage

AbbVie spends $350M to bolster healthcare, education; ‘We look forward to the impact we will make in the decades to come’ – Chicago Tribune

America’s Top 100 Charities – Forbes Magazine

As a support organization, Direct Relief works to equip medical providers in their own communities. Often, this occurs during times of unimaginable crisis, when people step into the unknown to help.

A 23-year-old in eastern Ukraine deciding to stay and help his community. A midwife reaching patients by watercraft after land routes were destroyed or cut off by wildfire. A mother, with her two children in tow, leading her family through the jungle to receive life-saving medical care in the U.S.

These, and many others, are a few of the individuals Direct Relief’s work has overlapped with over the past 12 months, and they reveal the creativity required to survive — and help others — along the way.

Here are some of their stories.

Jungle, Thieves, and Worse: A Mom’s Epic Journey To Save Her Daughter

 Alejandra Jimenez, 27, her husband, and her young daughter stayed in their hometown of Barquisimeto, Venezuela, for as long as they could. But when her daughter’s serious medical needs exceeded the care available, Jimenez made the decision to undergo the perilous journey from Venezuela to the United States. She and her family are among the 100,000 migrants who arrived in New York City from spring 2022 to August 2023.

To meet the health needs of those new arrivals, Ryan Health, a federally qualified health center, part of a national safety net clinic system that provides care for everyone who requests it regardless of their ability to pay, has stepped up.

“We reached out to the mayor’s office, catholic charities, and shelter providers in the area to offer our services because we suspected individuals would need health care,” said Daniel Pichinson, executive director of Ryan Health’s Chelsea-Clinton clinic, estimating that Ryan Health has onboarded about 3,000 migrants in the past year. Direct Relief’s Noah Smith and freelance photojournalist Oscar Castillo met Jimenez, as well as health providers meeting the needs of those seeking asylum in the United States.

Read more.

After Fighting Erupts in Eastern Ukraine, a Young Volunteer Steps Up

In May, Direct Relief’s Nick Allen met with a young volunteer in Eastern Ukraine, who was one of many whose world had been turned upside down after the Russian invasion but who quickly swung into action to help fellow Ukrainians.

“I want to be useful,” said 23-year-old Pavlo, whose last name was withheld for security reasons. Pavlo works with the Yevgen Pyvovarov Charity Fund to deliver aid to besieged communities in Eastern Ukraine.

Covid-19 had forced him to return home from a study abroad program in China, and the attack on Ukraine upended his plans once again. Pavlo and his family found themselves in occupied territory and eventually made it to Ukrainian territory. Declared unfit for military service because of a long-time knee injury, Pavlo had a decision to make: To endure the constant bombardments in Kharkiv city or head elsewhere, abroad even. “I had an opportunity to leave, but I declined. This is a decisive point for my country,” he said.

Read more of Pavlo’s story here.

Supporting Physical and Financial Health in Mississippi

Health providers screening for the social determinants of health — information about the conditions of a person’s life, from housing and transportation to access to clean air and water — is nothing new. Adding a picture of a person’s financial health and stressors, like debt burden, is a new angle.

It’s one the Aaron E. Henry Community Health Center, located in Clarksdale, Mississippi, is asking about to help their patients more holistically. It’s also the goal of the center’s Health Wealth program to address financial insecurity and its direct impact on health.

Aaron E. Henry received $100,000 from Direct Relief’s Fund for Health Equity, via the AbbVie Foundation, to launch the program with the goal that it serves patients across the Mississippi Delta, and could be replicated in health centers across the U.S.

Read more.

After the Fires, Providing Community Care in Maui

After devastating fires swept through Maui in August, local groups quickly mobilized to help those impacted. One of those groups, based in Oahu, worked to get medical care to people in any way possible.

The women of Healthy Mothers, Healthy Babies Coalition of Hawai’i and the nonprofit’s partners arrived at the site of the wildfire by jet ski, boat, and car to help those in need. Direct Relief has funded the group with emergency operating grant and has also shipped requested medicines to the group so they can continue their work providing care.

Read more.

Medical Interpreters Improving Health for Patients, One Conversation at a Time

During a medical visit, communicating the symptoms and state of one’s health is essential to receiving sound treatment and a diagnosis. For patients communicating in a language different than that of their medical provider, medical interpreters can help bridge the language gap, as well as advocate for their patients.

That’s exactly what a group of young interpreters with Centro Hispano de East Tennessee are accomplishing. They’ve expanded to include medical interpretation, one of the most requested services by both the Latino community, as well as the medical facilities in the area.

Centro Hispano received $186,000 from Direct Relief’s Fund for Health Equity, via Eli Lilly and Company, to develop a pilot program of medical Interpreters that will address current inequities by recruiting and training a group of multi-lingual youth seeking to learn new skills, join the healthcare workforce and serve their community.

Read more.

Direct Relief Equips Doctors Providing Care After Hurricane Otis

When Hurricane Otis, a devastating Category 5 storm inundated Mexico’s west coast, local groups jumped into action, including Medical Impact. After the storm left more than 100 hospitals and clinics damaged or destroyed, the group took medical care into the community to meet needs.

Read more.

Rehabilitation Effort in the Twin Cities Helps Ukrainians Recoup from War

Direct Relief’s Olivia Lewis traveled to Oakdale, Minnesota, to see the efforts of the Protez Foundation in action, which connects Ukrainians living with amputations to customized prosthetics and rehabilitation. Yakov Gradinar, a certified prosthetist and orthotist with the foundation, was working to fit people with prosthetics when Direct Relief visited the foundation in August.

Protez provides prosthetics to children and soldiers who have lost limbs during the Russo-Ukrainian War, and had provided over 260 high-quality prostheses and over 90 prosthetics. At the time of Direct Relief’s visit, six patients and their families were participating, the thirteenth group to take part in the program.

Read more about their work.

‘Death Just Beneath You’: Doctor Describes Turkey Earthquake, Ongoing Challenges

Dr. Yusuf Çekmece, 40, is a family medicine specialist based in Antakya, Turkey, which was hard hit by the devastating earthquakes on February 6, 2023, that killed more than 50,000 people.

Dr. Çekmece is part of the Turkish Medical Association, which Direct Relief has supported with grant funding to meet the needs of earthquake zone-impacted doctors, many of whom were displaced by the damage from February’s quake, including Dr. Çekmece. His home and office were destroyed, so he practices medicine from a shipping container and continues serving the community.

Read more.

“Providing Dignity to Humanity,” Free Clinics Expand Mental Health Care

About 85 miles northeast of Los Angeles, in the high desert, sit the ruins of George Air Force Base. From World War II through the end of the Cold War, activities on the site helped prepare pilots for battlefields worldwide. But today, a new fight is taking place at the decommissioned base.

Symba Center is a free clinic that operates out of a former gym that was converted into a wellness center for the community during the Covid-19 pandemic. Last year, Symba Center was among 11 free and charitable clinics which received a $75,000 grant to expand mental health care access to some of the most vulnerable populations in the United States. Over $17 million worth of mental health-targeted Teva pharmaceuticals were also made available to over 400 free and charitable clinics.

As a result of the grants, free and charitable clinics have been able to hire additional staff, launch internship programs, offer educational resources, including group sessions, increase collaborative efforts with local organizations and providers, and implement mental health screening programs for their patients. In total, these clinics have reached, directly and indirectly, about 22,000 people.

Read more.

According to a Penn State study from earlier this year that focused on children in Peru over a 15-year period, a link exists between experiencing a natural disaster or other similarly impactful economic or agricultural event and poorer testing outcomes across reading, vocabulary, and math, less food security, more time spent on household chores, and worse self-reported health outcomes. The study, authored by Carolyn B. Reyes and Heather Randell, found the effect cumulative, with poorer outcomes for those who had experienced multiple shocks.

Children who experienced these events later in childhood, between 12 and 15 years old, showed worse outcomes overall than those who experienced the events earlier on. The authors point to this older age cohort as being more aware of the event, being in the midst of either transitioning to secondary schooling or supporting their families by doing chores or working as potential reasons.

According to the United States Geological Survey, this data comes as natural disasters are increasing in both frequency and economic impact. In a 2021 report, the World Meteorological Organization found a fivefold increase in weather-driven natural disasters over the 50 years. However, resultant deaths have decreased by a factor of three in that same period.

Specific Vulnerabilities of Children

A 2016 survey of literature related to the impact of natural disasters on children by Carolyn Kousky of Resources for the Future, a Washington D.C.-based nonprofit research institute, shared similar findings as those reported by the Penn State team and outlined the ways in which natural disasters can harm a child’s mental and physical health as well as their educational outcomes over the long-term.

Kousky shared policy recommendations for ways to mitigate such damage, including reinforcing school buildings and homes and placing more emphasis on reuniting families as soon as possible following a disaster. She also highlighted the potential value of supporting existing safety net health care clinics and organizations instead of spinning up new initiatives in the wake of an event.

Kousky, Reyes, and Randell all acknowledged the relatively small sample sizes and specific geographic contexts of much of the existing research but still found pervasive indications that natural disasters harm children’s health in a variety of ways. Kousky identified that children, especially younger children, in contrast to the Peru study, may be more vulnerable than other age groups since they rely on caretakers who might be unable to care for them and are less protected from physical damage due their developing bodies, an example being that children are more at risk of dehydration due to the smaller amount of fluids in their bodies compared to adults.

In severe disasters, children have been found to be less likely to survive compared to adults, such as in the 2004 Indian Ocean tsunami, according to a 2011 study in Economic Journal, which was included in Kousky’s report.

Economic Impacts on Families and Children

On the economic side, the ability of families to stay financially resilient after a disaster depends upon a range of factors, but chief among them, across the studies reviewed by Kousky, Reyes, and Randall, was access to credit and, as reported by Kousky, insurance. Without these resources, families are forced to make do with their savings.

A natural disaster and the resulting financial impact can have dire consequences for children, as families may be forced to decrease their investments in education and might result in children being forced out of school in order to work, as was reported in this year’s Peru study. However, it remains challenging to get more granular causal data as opposed to the correlations being shared.

Health and Nutritional Impacts

Economic conditions can also translate directly into physical health conditions, as families may be unable to access the same amount of nutritious food as before the event. Access to medical care and medications is often impacted as well. Kousky shared that people living in FEMA housing in 2005, following the previous year’s Hurricane Katrina, faced “fragmented” or “nonexistent” access to medical care. In particular, many children were unable to obtain their asthma medication.

Survivors living in FEMA housing at that time also reported high levels of negative mental health impacts on their children. Specifically, half of all parents surveyed said at least one of their kids was experiencing an emotional issue that they did not have before the storm. In a different study, decreases in PTSD symptoms in children were found to occur two and three years after the storm, though more than a quarter of kids still had symptoms after three years.

Assessing additional ways to prepare for disasters, Kousky said that many nondisaster programs can be effective in recovery efforts, including increasing access to credit, offering subsidies for families to maintain continuity of education for their children, and increasing unemployment insurance.

In 2023, Direct Relief provided medical aid to more than 85 countries during both times of disaster and as part of ongoing support. The organization is focused on meeting the health needs of those most vulnerable to disasters, including children.

One free clinic located in the epicenter of the opioid crisis has gone above and beyond to save lives and connect those with substance use disorder to lifesaving resources, including opioid-overdose-reversing naloxone.

This video, produced by Pfizer and Direct Relief, highlights the efforts of Milan Puskar Health Right, a free clinic that offers harm reduction services in Morgantown, West Virginia.

The state has the highest opioid overdose death rate in the U.S., according to 2021 data from the Centers for Disease Control and Prevention. To address demand, the clinic has expanded to offer comprehensive harm reduction services, including the distribution of naloxone to those with substance use disorders and their families.

Over the past five years, more than 2.6 million doses of naloxone have been provided at no charge to organizations in all 50 U.S. states and three territories.

The shipments contained 7.2 million defined daily doses of medication and supplies, including insulin, vaccines, emergency hygiene kits, and personal care products.

Tennessee Tornadoes

Over the past weekend, tornadoes impacted multiple counties in Tennessee, killing at least six people and injuring at least two dozen more.

In response to the storms and tornadoes in Tennessee, Direct Relief sent offers of assistance to health centers and clinics in impacted areas.

In response, an initial shipment of 50 personal care kits arrived at Faith Family Medical Clinic. The kits contain items such as toothbrushes, soap, and other essentials for people displaced from their homes due to the storms.

Requested shipments of chronic disease medications, as well as vitamins and nutritional products, departed earlier this week for Neighborhood Health, a community health center with multiple locations in Davidson and Wilson Counties.

Supporting Maui Residents After the Fires

Last week, volunteers packed 5,000 kits of personal protective equipment, including gloves and boot covers, at Direct Relief’s headquarters in Santa Barbara. These kits will be shipped to Maui and provided for free to people re-entering Lahaina after the devastating fires in August.

OPERATIONAL SNAPSHOT

WORLDWIDE

This week, Direct Relief shipped 4.2 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 452 shipments containing almost 13 tons of medications over the past week to organizations, including the following:

YEAR-TO-DATE (GLOBAL)

Since January 1, 2023, Direct Relief has delivered 21,000 shipments to 2,503 healthcare providers in 55 U.S. states and territories and 88 countries.

These shipments contained 541.3 million defined daily doses of medication valued at $1.9 billion (wholesale), totaling 6.1 million lbs.

IN THE NEWS

Direct Relief ranks fifth in Forbes top 100 largest U.S. charities – KEYT

America’s Top 100 Charities – Forbes Magazine

How To Use Forbes’ Top Charities List To Guide Your Own Giving – Forbes

Direct Relief, which is funded entirely by private charitable contributions and does not accept government support, prioritizes operational efficiency through strategic partnerships with businesses and organizations. The vast majority of the donations it receives and distributes consist of in-kind donations of medicine and medical supplies. These contributions, valued at their wholesale cost, comprise the predominant share of the organization’s annual revenue.

Forbes awarded Direct Relief a score of 99% for charitable commitment (how much of a charity’s total expenses go directly to the charitable purpose) and 100% on fundraising efficiency (the percent of private donations remaining after deducting fundraising costs).

Forbes also ranked California-based Direct Relief as the largest of the six California charities included in its 2023 list.

Direct Relief, one of the world’s largest channels for humanitarian medical assistance to underserved communities and survivors of disasters, also ranks as the second largest charity in the “International Needs” category, according to Forbes.

Direct Relief in 2023

Doctors, midwives, community health workers, and other health professionals working in public-benefit health organizations around the world rely on Direct Relief to equip them with the medical resources they need to care for any patient, without regard to politics, religion, or ability to pay.

In its 2023 fiscal year, Direct Relief provided assistance in the form of essential medications, a broad range of medical supplies, and financial support in response to requests from healthcare providers and other local organizations across 88 countries and 55 US states and territories. The 2,900 tons of medical essentials provided by Direct Relief included 534 million defined daily doses of specifically requested medications, vaccines, insulin, and biologic therapies. The organization also provided $77 million in financial assistance through grants for a variety of emergency response and public-health related purposes.

In 2023, Direct Relief once again sustained and expanded existing programs while also responding to humanitarian emergencies globally. The organization’s continuing response to the war in Ukraine – now exceeding $1.5 billion in humanitarian assistance – remains the largest mobilization of medical resources in Direct Relief’s history.

Direct Relief’s longstanding approach of supporting locally run facilities providing essential health services to underserved communities has enabled the organization to distribute more medicine and supplies and strengthen fragile health systems in more places than ever before in its 75-year history. 

Since January 1, 2023, Direct Relief has:

• Donated insulin to 40,332 children with Type 1 diabetes in 32 countries.
• Provided more than 460,000 doses of lifesaving naloxone to health centers, free clinics, community organizations and harm reduction groups in the U.S.
• Delivered critical rare disease therapies to treat more than 600 patients in 17 countries.
• Launched projects to provide resilient energy solutions to 41 healthcare facilities in California, Florida, Louisiana, and North Carolina, projected to yield an estimated $4.3 million in cost savings annually.

2023 Charity Ratings

In addition to its top ranking from Forbes, Direct Relief earned a four-star rating from Charity Navigator, America’s largest independent charity evaluator.

This recognition marks Direct Relief’s 13th consecutive four-star rating and the first time it has been evaluated in Charity Navigator’s Impact & Results beacon, where its 100% rating contributed to an overall perfect score across the key nonprofit performance indicators Charity Navigator assesses.

Direct Relief also retains an A+ rating from Charity Watch, the highest score given by the independent charity watchdog.

Direct Relief, which receives no government funding and is supported entirely from charitable contributions, has a longstanding commitment to efficiency and frugality in all its organizational activities, including fundraising activities.

Direct Relief’s revenue includes both gifts of medications and other medical commodities and cash. Direct Relief believes it important to note that revenue associated with medical product contributions obviously may not be used for fundraising purposes, and that its modest fundraising expenses average about 2 percent of its total cash revenue. The organization pays all such fundraising expenses with earnings from a generous bequest, which means that zero percent of donated funds are used for the organization’s fundraising activities.

To learn more, please read the Direct Relief 2023 Impact Report.

Direct Relief’s Fund for Health Equity provides financial support to community health centers, free and charitable clinics, educational institutions and other community-based organizations fighting the inequities that further health disparities. Since 2021, Direct Relief, through the Fund, has granted more than $42.5 million to 145 organizations across the U.S.

This week, representatives of these organizations are coming together to meet and share their learnings in Santa Barbara, California. Their efforts, which span the country, include serving refugee populations in North Dakota, providing medical translators in Tennessee, operating a mini nurses academy in Alabama, running a clinic focused on health and financial health in Mississippi, conducting street medicine outreach in Chicago, and offering indigenous health services on the Northern Cheyenne reservation.

The summit’s agenda includes sessions on diverse topics such as data-driven storytelling, community health worker strategies, mobile health services, street medicine, maternal care, mental health, and prevention strategies, all viewed through a health equity lens.

Dr. Regina Benjamin, U.S. Surgeon General during the Obama administration and Founder and CEO of BayouClinic in Bayou La Batre, Alabama, addressed the audience Tuesday morning, emphasizing the importance of health equity and the critical roles nonprofits play in advancing health equity.

Dr. Benjamin also serves on the advisory council of Direct Relief’s Fund for Health Equity.

“You are part of an entire movement to make this a healthier nation,” she told the audience.

Daniel Dawes, Senior Vice President of Global Health & Executive Director of the Global Health Equity Institute and Founding Dean of the School of Global Public Health at Meharry Medical College, delivered the keynote address examining the country’s 400-year history of health inequities.

The inequalities seen in U.S. society — past and present — were not an accident and will take concerted political effort to undo and rectify, he said.

Dawes spoke about the “political determinants of health,” constructed barriers that keep people from living healthy lives. Dawes stressed that effective policy change is essential for rectifying these long-standing issues. Social determinants of health, like access to housing, clean food and water, and timely medical care, are often discussed, but “underlying each one is a political determinant that we can no longer ignore,” he said.

Policies that intentionally excluded healthcare for people who worked in agricultural industries and as domestic workers, highway planning that placed roads through under-resourced communities, exposing them to air contaminants, and housing policies like redlining are all examples.

“Only policy can fix what policy created,” he said.

Dawes encouraged the audience to continue their work and pointed to examples of change occurring when policy and local efforts combine. “It gives me a sense of hope about how much we can accomplish together,” he said. “This movement is not for the faint of heart. It takes tremendous courage.”

Dawes also took part in a panel discussion on the importance of collaboration and proactive health strategies with Dr. Benjamin and two other advisors of Direct Relief’s Fund for Health Equity Advisors, including Gail Small, Head Chief Woman and citizen of the Northern Cheyenne Tribe, and Martha Dawson, President and CEO of the National Black Nurses Association and Associate Professor at the University of Alabama at Birmingham.

Dr. Benjamin encouraged the conference participants to continue the work at the local level.

“Leadership starts in this room,” she said.

More than 15,000 people were without power on Monday, and shelters have been activated for people displaced from their homes due to the infrastructure damage and power interruptions. Three people were killed in Davidson County, which includes Nashville, and there other deaths were recorded in Clarksville in Montgomery County, located on the Tennessee-Kentucky border.

Direct Relief has offered assistance to health centers and free clinics in impacted areas. Direct Relief is in communication with the Faith Family Medical Clinic, Matthew Walker Comprehensive Health Center, Neighborhood Health, Siloam Health, and University Community Health, all located in Davidson County, Tennessee. The organization is also reaching out to facilities in Montgomery County about potential needs.

In addition to acute injuries from flying debris and structural damage, tornado impacts can also create a host of other health concerns, including a lack of access to chronic disease medications, which can result in emergency room visits.

Direct Relief maintains an inventory of medications commonly requested after disasters and has responded to past tornadoes in the region, most recently in December 2021, when tornadoes wreaked havoc across multiple states, including several of the areas impacted by this week’s storms.

The organization will continue to respond to needs as they become known.

The shipments contained 15.5 million defined daily doses of medication and supplies, including prenatal vitamins, insulin, rare disease therapies, personal protective equipment, and chronic disease medications.

One of this week’s recipients was Care Beyond the Boulevard, a Kansas City-based organization dedicated to providing medical care to those living without permanent housing.

The group received donated medications and supplies, including insulin, nutritional supplements, and anti-inflammatories.

Additionally, over 4.7 million N95 masks departed Direct Relief’s warehouse this week for the Ministry of Health of Baja California. They will be distributed to multiple groups and government agencies in the region.

OPERATIONAL SNAPSHOT

WORLDWIDE

This week, Direct Relief shipped 13.6 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 532 shipments containing more than six tons of medications over the past week to organizations, including the following:

YEAR-TO-DATE (GLOBAL)

Since January 1, 2023, Direct Relief has delivered 20,500 shipments to 2,485 healthcare providers in 55 U.S. states and territories and 88 countries.

These shipments contained 534.2 million defined daily doses of medication valued at $1.9 billion (wholesale), totaling 6.1 million lbs.

IN THE NEWS

Health for All: Reflections on the Universal Declaration of Human Rights on its 75th Anniversary – LinkedIn

“It’s Amazing What Can Be Done Here.” Colorado Health Center Offers Community for Those in Recovery – National Association of Community Health Centers

Veterans Stand Down 2023 Helps More than 400 Military Vets – The Santa Barbara Independent

United We Bake Harnessing Power of Comfort Food to Aid Direct Relief’s Efforts in Israel and Gaza – Noozhawk

Meharry SACS Students Named Direct Relief Scholars – Meharry School of Applied Computational Sciences

Each year, before storm season begins on June 1, Direct Relief assembles and stages large caches of emergency medical supplies and collaborates with national health care and emergency response authorities in countries located in storm-prone regions.

Prior to the 2023 hurricane season, Direct Relief strategically placed emergency medical supplies in every Southeastern and Gulf Coast state of the United States, from Virginia to Texas, along with several locations throughout the Caribbean and Central America.

These hurricane preparedness packs contain the most commonly required medical supplies during and after a disaster, including trauma supplies, wound care supplies, and antibiotics. Additionally, they also contain medications for conditions like diabetes, hypertension, respiratory problems, psychological issues, and gastrointestinal problems.

This season, Direct Relief responded to the health needs that arose after three major storms, namely Hurricane Hilary, Hurricane Idalia, and Hurricane Otis. Direct Relief is currently continuing its response to these storms.

Hurricane Hilary

Hurricane Hilary formed on August 16, off the western coast of Mexico, and quickly grew into a Category 4 storm. It later weakened into a tropical storm before making landfall in Baja California. This was the first tropical storm to enter California since 1997. It continued to cause flooding as it moved across the southwestern United States and eventually dissipated over the Rocky Mountains.

Direct Relief took proactive measures before Hurricane Hilary made landfall by communicating with state and local organizations in Mexico to identify potential medical needs. Prior to the storm, Direct Relief supplied 18 emergency medical backpacks to the State of Baja, California, to equip first responders with medical essentials for triage care outside of clinic walls.

After the hurricane, Direct Relief sent additional medical support to the State of Baja California Sur, including ten emergency medical backpacks and an emergency health kit containing essential medicines and supplies usually requested after disasters.

These supplies were sent to Fundacion Astra in Baja California Sur, a non-profit organization that provides acute and preventive health services to vulnerable populations such as mothers and children, at-risk youth, injured and chronically ill people, and older adults.

Direct Relief was established as a Civil Association in Mexico in 2014 and has been an authorized donee since 2015. It is the only humanitarian wholesale distributor of pharmaceuticals in Mexico that fully complies with COFEPRIS regulations. This means Direct Relief can receive and process donated goods, and it’s well-positioned to respond to both immediate public health requirements and long-term healthcare service needs in underserved communities.

Hurricane Idalia

Hurricane Idalia began as a tropical depression in the Caribbean and eventually made landfall at Keaton Beach on Florida’s northern gulf coast, specifically in the Big Bend region, on August 30. This was the first major hurricane on record to hit this part of the Big Bend, and it caused significant damage to trees and structures across multiple counties. The hurricane brought winds of up to 125 mph and a storm surge of seven to 12 feet.

In preparation for Hurricane Idalia, Direct Relief had positioned 14 hurricane preparedness modules across Florida. Each module contained enough medical supplies to treat 100 patients for various conditions such as trauma injuries and chronic illnesses for a 72-hour period. The caches were strategically placed in secure locations near vulnerable areas, with seven of them located within the path of Hurricane Idalia.

After the storm, Direct Relief coordinated with the Florida Association of Community Health Centers and the Florida Association of Free and Charitable Clinics to provide more than one ton of requested medications and medical supplies, including insulin, wound care items, vitamins, and antibiotics, to healthcare facilities in these associations’ networks across Florida.

In North Miami, Mercy Mobile Clinic Provides Care Amid Chaos

One organization that provided crucial care in the aftermath of the hurricane was the North Miami Beach Medical Center. The center has been offering on-site medical assistance to victims of disasters since 2004 through its mobile health unit, which was purchased with the help of Direct Relief. When Hurricane Idalia struck their community in August, the center immediately sprang into action, providing healthcare services to the injured and those who had lost their medications and medical supplies in the storm, within the shelter setting.

People staying at the shelter reported multiple medical needs, including coronary artery disease, hypertension, diabetes, asthma and Parkinson’s disease. There were also those with injuries, including people experiencing homelessness, older adults and young children, who were treated. Two medical team members also went to those living in damaged homes to help and encourage them to come out to the shelter.

During the storm, some people with behavioral health conditions lost access to their required treatments. The Mercy Mobile team provided prescriptions and arranged for medications to be delivered to the shelter.

In the subsequent days, clinic staff treated approximately 150 patients.

Hurricane Otis

Hurricane Otis, a Category 5 storm—the strongest hurricane to hit Mexico’s Pacific Coast in recorded history—made landfall in Acapulco, Mexico, on Oct. 25, 2023, killing dozens with more still missing.

Property damage from the storm is also extensive. Otis damaged 80% of the hotel infrastructure and 96% of businesses in a city that lives mostly from tourism. More than a month after the storm, business owners and employees are still clearing debris and rubble from the streets.

Direct Relief and FedEx collaborated to pre-position three emergency health kits in Chilpancingo Guerrero, Mexico ahead of Hurricane Otis. Additionally, Direct Relief provided 53 field medic packs, containing medical essentials for providing care outside of clinic walls to health providers on the ground.

After the storm, Direct Relief immediately pledged $200,000 to support medical care providers on the ground. The organization also dispatched additional supplies to assist first responders in search and rescue operations and to help healthcare professionals in the aftermath of the hurricane.

Among the groups that received support from Direct Relief was Medical Impact, which was granted an emergency operating fund of $25,000. The group sent 12 doctors to Acapulco to provide medical aid in the affected area. The medical providers were equipped with field medic packs and an emergency health kit from Direct Relief, which included essential medical supplies commonly requested during disaster situations.

During the first week of November, Direct Relief coordinated the delivery of 20,000 liters of diesel to power the backup generators at Acapulco’s general hospital. The hospital was running out of fuel and required the generators to keep functioning. To help prevent the spread of disease, Direct Relief also delivered 100,000 units of hand sanitizer to the regional ministry of health. These units were then distributed to affected communities. Direct Relief is continuing to receive requests and assess needs, and more donations are forthcoming.

In Colorado, a federally qualified health center has provided access to healthcare and quality housing for decades. Now, the health center’s Fort Lyon location is celebrating a decade of successful substance use recovery, too.

The Denver-based health center, the Colorado Coalition for the Homeless, began offering healthcare services to those experiencing homelessness 40 years ago. The founders realized that housing was a critical part of maintaining overall health needs and began purchasing property so patients could have a place to call home.

Now, the Coalition owns over 2,000 affordable, supportive housing units for individuals and families and has repurposed a Veterans Hospital-turned-correctional facility for those with substance use disorders to live while in recovery.

Health, housing, and flexibility are the secrets to the program’s success. According to Fort Lyon, over 40% of their participants exited the program and moved into permanent housing. When transitional, long-term care was included, 58% of participants moved into permanent housing. Last year, 93% of participants said they were satisfied with their experience at Fort Lyon.

“It’s amazing what can be done here,” said Vincent Orzweiler, a current participant in the Fort Lyon program. The 62-year-old said he has struggled with alcohol dependency for 30 years. He’s tried other recovery programs in the past but said many are expensive and only allow participants to stay in recovery over strict timelines.

November marked 19 months at Fort Lyon for Orzweiler, who says he has taken a deep dive into his mental and behavioral health to better understand the reasons he consumes alcohol.

“Mentally, it’s about filling a void, the spiritual intersection of addiction,” he said. “There are mental problems that we all go through, and there are reasons that we became addicts.”

Before moving to Fort Lyon, Orzweiler had a new job and said that life was going well.

“I thought I could go back and maybe use a little here and there because my life was better,” he said. “But that addiction took control again, and I ended up losing almost everything again.”

Frustrated, his friends and family encouraged Orzweiler to seek out social services. He completed an application and was referred to Fort Lyon.

No Place for Isolation

There are few rules at Fort Lyon, other than joining at least one of the many recovery groups on site. Isolation is not an option, and enrolled participants are at Fort Lyon because they want to be there.

The program can accept up to 225 applicants at a time through referrals from social services across the state. The program is free to participants, at a cost of $18,800 per person per year for the state. Participants can stay at the facility for up to three years while working on their mental and behavioral health needs. The participants are predominantly male, at 80%. About 68% of participants are from counties outside of Denver, and most participants are between the ages of 45 and 54.

Fort Lyon is located in Colorado’s Bent County, a rural area with less than 6,000 residents and the program has been home to over 2,200 people in the past decade. Patients have access to the on-site health clinic, can choose from dozens of workgroups to participate in, go to school to gain certifications and become employed to begin rebuilding their lives. They are housed across three dormitories and 10 single-family homes across the campus.

That community has been key to Orzweiler’s recovery. He said that he is prioritizing his mental health and has learned that he needs a supportive network around him. When he leaves, he’ll return home and plans to find a therapist to continue working on his mental and behavioral health needs.

“I had to change a lot of behaviors, and it’s not just the using part,” he said. “It’s the things that I would say made me a better human being. A better citizen…Why did I cheat? Why did I steal? Why do I lie? It’s all part of the addiction, and those issues have to be addressed.”

Orzweiler said that he and many others felt “beaten down” by life tolls when they arrived to the facility. After months of therapy, he says he can’t overstate how important the mental health side of his recovery has been at Fort Lyon.

Patients expressing their own desire for recovery is also why Fort Lyon has been successful, said Lisa Trigilio, operations director. Trigilio has worked at Fort Lyon since its inception as a recovery facility. She said the “loose program” doesn’t have a lot of requirements, thus increasing the chance for patient success.

“For me, it’s the phenomenal amount of people that you meet,” she said about why she enjoys working at Fort Lyon. “We have so many wonderful people that come through here, and it just excites me to see when people are changing.”

Participants can choose whether their recovery is faith-based, medically assisted, involves group therapy, or a myriad of other options. They’re allowed to leave campus to explore the town, often to eat and find local employment. Fort Lyon is also not a closed facility—those seeking help for substance use disorders are welcome to join the on-site group discussions.

Trigilio said many have arrived at Fort Lyon feeling “very broken” and that they leave feeling “excited about life again.”

“You can’t find that anywhere else that I know of,” she said.

Fort Lyon’s health center is a satellite center to the Denver location. A physician is available two days a week, as well as a licensed professional counselor and a psychiatric nurse practitioner. They offer in-person and telehealth options. The medical services are free for participants through the state’s Medicaid program. All staff are trained to administer Naloxone, and if comfortable, carry it with them while at work.

“Taking a comprehensive history is important. Many of the patients I work with not only have addiction but also mental health concerns, co-occurring disorders,” Vickie Lucero, an on-site behavioral health provider, told Direct Relief in an email.

Lucero said that she asks patients about previous trauma, treatments and outcomes. Lucero teaches healthy boundaries, and talks to her patients about how to communicate and prioritize self-care. Many arrive at Fort Lyon with unaddressed medical issues, which can affect their overall treatment plan.

“Addressing addiction requires addressing the whole person,” Lucero wrote. “Trauma, pain, grief, education, employment (and more). They all impact how an individual copes with the challenges of life. At FLHC, we work to address all those things with care and compassion, taking care of the whole person.”

Direct Relief has supported the Colorado Coalition for the Homeless with medical aid and financial support, including a $100,000 emergency operating grant to continue work during the Covid-19 pandemic.

The shipments contained 25.4 million defined daily doses of medication and supplies, including prenatal vitamins, protective equipment, rare disease therapies, cancer treatments, and chronic disease medications.

Power and Health Summit Convened at Direct Relief

The intersection of climate and health was the focus of a panel discussion and film screening at Direct Relief this week. On Thursday, a screening of the short documentary “The Climate and Us: Invisible Impacts of Wildfires,” a co-production of Direct Relief and BBC’s StoryWorks, was shown in Direct Relief’s Hatch Hall in its Santa Barbara headquarters.

The film explores the aftermath of the 2018 Camp Fire on the Northern California community of Paradise, and how a local health center continues to help the area recover. The short film can be seen below.

The event also featured a panel discussion, featuring Former President of Navajo Nation Jonathan Nez, UCSB Professor of Economics Olivier Deschenes, and Washington Post Climate Reporter Brianna Sacks. The panel was moderated by Direct Relief CEO and President Thomas Tighe, and covered resiliency, climate and disaster planning for who is most at risk during a disaster: those most vulnerable the day before, including young children, older adults, people living with disabilities, those for whom English is a second language, and those with limited transportation options.

More than 100 power resiliency projects in 10 countries, Direct Relief’s Power for Health initiative seeks to bring clean, renewable backup power to community health centers and free clinics to ensure they can deliver critical healthcare services during power outages.

Without power, critical health services can’t be provided – lifesaving medicines go bad, electronic health records can’t be accessed, essential medical equipment can’t be powered, and vital community health facilities serving the most vulnerable shut down. This initiative addresses health equity, the need for renewable energy, and community resiliency.

Learn more about the initiative here.

OPERATIONAL SNAPSHOT

WORLDWIDE

This week, Direct Relief shipped 23.2 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 585 shipments containing more than six tons of medications over the past week to organizations, including the following:

YEAR-TO-DATE (GLOBAL)

Since January 1, 2023, Direct Relief has delivered 20,100 shipments to 2,461 healthcare providers in 55 U.S. states and territories and 88 countries.

These shipments contained 532.6 million defined daily doses of medication valued at $1.9 billion (wholesale), totaling 6 million lbs.

in the news

Pac Biz Times reports: Direct Relief reaches milestone in aid to U.S. nonprofits – KEYT

Direct Relief shares ways you can give this holiday season – News Channel 9

EMS Agency visits Direct Relief to fight opioid epidemic – KEYT

Walmart Foundation commits $1 million to support humanitarian aid in Gaza – Yahoo Finance

Direct Relief Improves the Health and Lives of People Affected by Poverty or Emergencies – Noozhawk

Direct Relief tallies $2B in aid to U.S. nonprofits – Pacific Coast Business Times

Santa Barbara restaurant collaborates with Direct Relief to help those affected by Maui wildfires – KEYT

People continue to grieve the losses—at least 97 people were killed—while navigating the new normal for daily life. Homes and businesses were destroyed, and displaced over 6,000 residents who continue to live at nearby resorts. With years expected for rebuilding, children have returned to school in new formats, like learning at home, in church buildings, or being bussed to new schools farther away. As all of these changes are made, residents are working together to limit the amount of re-traumatization that may happen.

Dr. Felicitas Livaudais, a pediatrician at the Kihei Clinic, said the multi-generational aspects of Hawai’ian culture are highlighted in how residents say goodbye and grieve their losses. The pediatrician said the community has prioritized healing ceremonies, visiting the burn site to say goodbye to their properties, and taking part in paddle outs for surfers who host ceremonies and lay flowers in the ocean.

In September, the federal government sent 25 public health officers to Maui to assist with behavioral and support services. Public health officers included psychologists, psychiatrists, social workers and nurse practitioners to offer education, complete assessments, and medical health referrals.

“Tragedies like the Maui wildfires have a profound human impact on communities,” said Assistant Secretary for Preparedness and Response Dawn O’Connell in a September news release. “We are committed to doing all we can to assist the people of Hawai’i, and we are working with partners on the ground to assess ongoing needs to support recovery efforts.”

The following month, local health centers and organizations worked together to offer a community health fair. Residents received flu and Covid-19 vaccines donated by Direct Relief, hygiene necessities to take home, haircuts, massages, and culturally important gifts like ukuleles. Medical professionals in the area reported over 2,000 people attended the event.

Dr. Livaudais was one of the doctors on hand at the health fair to administer vaccines to children and adults, and said that supporting people with physical and behavioral health will require culturally competent practices.

In Maui, cultural traditions and beliefs are of utmost importance, and community members are trying to incorporate those practices into healing work through culture, connection, and conditions.

One example is serving musubi, a popular Hawaiian snack made of spam in a teriyaki sauce with rice wrapped in nori, during twice-weekly “Talk Story” community meetings where people are encouraged to gather together to thwart isolation.

“The community is really trying to help each other,” Livaudais said. “It’s hard, but there’s a lot of community support.”

According to the American Psychiatric Association, most people who experience a natural disaster will eventually return to their original level of functioning. However, sadness, depression, difficulty falling asleep or concentrating, and a feeling of numbness are common issues following a tragedy.

The Hawaii Department of Health conducted a needs assessment that found the greatest needs of residents were financial recovery and finding a permanent residence, followed by access to employment. According to the Department, 41% of survey respondents reported a decline in a household member’s health following the fires, and 22% reported their mental health as poor or very poor.

In an email to Direct Relief, a Department of Health representative said that the behavioral health impact of the Maui fires is expected to be significant and long-lasting and that they expect behavioral health needs to grow as the community grieves. The Department said they are making community mental health services accessible, like telehealth grief counseling and in-person therapy.;

A lack of permanent housing has contributed to stress and anxiety. According to the American Red Cross, 6,643 residents, or 2,748 households, within the non-congregate shelter program were housed at local resorts in late November.

Dr. Cassandra Simonson, a pediatrician at Mālama I Ke Ola Health Center, said that the community has tried to respond to as many requests for help as possible—including birthday cakes for kids, clothing needs, and a job opportunity for a musician. She said that while resources are available, some people remain “frozen, and unable to pivot” because they don’t have anyone to talk to and figure out how to move forward after losing everything.

Both physicians expressed concern about the mental health of health workers and first responders and have changed processes to limit emotional distress for patients and providers. In the first two months after the fires, providers asked patients intake questions to determine whether patients had housing and if their families had survived; they have since changed those methods because the questions increased patients’ emotional distress.

Instead, the health center uses sensory-inclusive rooms and play therapy to work with families. The rooms have low lighting, a “crash place” for children to lie down, a fish tank with bubbles, and the option to listen to music or play with toys. Originally intended for autism evaluations, the room is also useful for fire victims.

“It’s just so soothing, and even the parents have said that they felt calmer in those rooms,” Simonson said.

Air quality has been a top concern for her patients’ parents as children re-enrolled in school. Many were supposed to be bussed from one side of the island to the other, passing through the burn site twice daily on the school bus. Simonson warned that driving through the burn site every day could be triggering for children who had to flee their homes.

To better support the many children who survived the fires, doctors statewide are working on a hotline for children who may be in mental distress. Volunteers will answer the phones and point parents and relatives to resources for child psychiatrists, which can be difficult to access without a specific insurance carrier.

“If we can establish safety, at least a general feeling of safety, that’s the goal,” she said.

Direct Relief supported Malama I Ke Ola Health Center and other community organizations during the Keiki Health Fair for Lahaina residents in Ka’anapali, Maui, when over 2,000 people attended to receive physicals, donated vaccinations from Direct Relief (RSV, flu, Covid-19, and TDAP), and to have lost medical records recreated. Direct Relief has supported Malama I Ke Ola Health Center with medical aid since the fires and also with emergency operating funds.

In 2023, Direct Relief once again demonstrated the effectiveness of its flexible approach across all of its programmatic priorities. The organization sustained and expanded existing programs while also responding to humanitarian emergencies globally. The organization’s continuing response to the war in Ukraine – now exceeding $1 billion in humanitarian assistance – remains the largest mobilization of medical resources in Direct Relief’s history.

Direct Relief’s longstanding approach of supporting locally run facilities providing essential health services to underserved communities has enabled the organization to distribute more medicine and supplies, and strengthen fragile health systems in more places than ever before in its 75-year history. This report provides an overview of how Direct Relief has leveraged contributions from generous individuals, companies, and foundations to improve the health and lives of people affected by poverty and emergencies in 2023.

2023 AID TRACKER
Unaudited totals through November 1, 2023

• $1,779,114,181 in medical assistance
• $51,300,000 in financial assistance
• 458,049,778 Defined Daily Doses of medicine
• 5,537,556 pounds of medicine and supplies
• 17,975 deliveries
• 2,371 healthcare providers supported
• 87 countries

Thank you for being part of Direct Relief

EMERGENCY RESPONSE ON A GLOBAL SCALE

Responding to humanitarian crises requires rapid mobilization of the right kind of assistance to the right partners at the right time. Direct Relief responds to emergencies using state-of-the-art data tools and guidance from its extensive global network of vetted partners. The result is swift and always tailored to specific requests from local front-line health workers. Coordination with other organizations and public agencies ensures the most efficient and precise use of resources.

The Right Products: Turkey/Syria Earthquake

A 7.8-magnitude earthquake in Turkey and Syria left 100,000 people injured and destroyed hospitals and health clinics. Within 48 hours, Direct Relief began shipping requested supplies to help establish temporary medical facilities.

In its continuing response to the disaster, Direct Relief has delivered $92 million (wholesale) in material assistance, including:

• 63 million defined daily doses of vital medications
• 945 Direct Relief Emergency Medical Backpacks to equip first responders
• 3,680 Direct Relief Hygiene Kits for 18,400 displaced persons
• Prefabricated temporary housing for medical workers

Medicine and Money to Maui

The West Maui Wildfire destroyed the town of Lahaina, disproportionately affecting residents who are low-income, elderly or very young, pregnant, or who have chronic medical conditions. People with chronic conditions may face acute medical crises if they evacuate without their medications. Wildfires generate airborne particulates that can worsen respiratory and cardiovascular disease.

Direct Relief responded within 24 hours with a commitment of $500,000 in cash assistance to maintain health services. The first emergency shipments of requested medical essentials, including asthma inhalers, diabetes medicines, antibiotics, pain relief, wound care products, and cardiovascular medications, followed within days.

Data and Emergency Preparedness

When responding to natural disasters, displacements, and disease outbreaks, time is of the essence. Early detection and early response lead to better outcomes. Direct Relief can quickly provide the right assistance to the right places at the right times by linking real-time disaster data with information about community-level vulnerability, hazards, and losses.

Each year, Direct Relief leverages data analysis to pre-position materials needed to rapidly respond to hurricanes and efficiently mobilize in response to wildfires. Direct Relief monitors population movement, tracks disaster effects, and remains responsive to evolving circumstances in the affected areas.

STRENGTHENING HEALTH SYSTEMS

Direct Relief works to improve the health of people living in high-need areas by strengthening fragile health systems and increasing access to quality health care. The organization’s medical assistance programs equip health professionals who serve vulnerable populations, and increase access to medicine for patients who would otherwise go without.

Broadening Access to Cold Chain Medicines

Increasingly, new vaccines and medications for cancer, genetic diseases, diabetes, and other medical conditions require consistent cold temperatures (cold chain medicines) from the point of manufacture until dispensed to a patient. Communities that lack the infrastructure, power, and systems required to handle such medications properly, often go without these therapies.

Direct Relief improves cold chain infrastructure by providing cash grants, donations of refrigeration equipment, and expertise. In 2023, the organization delivered pharmaceutical-grade cold storage equipment to 113 healthcare facilities in low-resource communities.

With this support, health workers can store and administer important temperature-sensitive medicines for a range of conditions.

In 2023, Direct Relief delivered:

• 67 shipments of cancer treatments to 35 healthcare facilities in 24 countries
• Insulin to manage diabetes for 40,332 children with Type 1 diabetes in 32 countries
• Critical rare disease therapies to treat more than 600 patients in 17 countries

Increasing Access to Resilient Power

Modern healthcare relies on continuous power. Increasingly, record-setting emergencies result in extended power shut-offs. With healthcare systems’ growing dependence on power to provide treatment and maintain patient records, thousands of patients go without care when the power goes out.

Direct Relief’s Power for Health initiative promotes health equity by providing site-specific, reliable power to nonprofit community clinics and health centers serving the most vulnerable communities throughout the U.S. The initiative has already launched projects to provide energy solutions for 41 healthcare facilities in California, Florida, Louisiana, and North Carolina, benefitting 1.3 million low-income patients. These projects have created an estimated $4.3 million in annual cost savings for the participating health facilities.

GETTING PATIENTS THE CARE THEY NEED

Cancer, cardiovascular disease, and diabetes have become responsible for the highest shares of death and disability globally. Cancer alone has become the leading cause of death worldwide, and approximately 70 percent of cancer deaths occur in low- and middle-income countries. Direct Relief has responded by increasing its delivery of medical products and financial assistance to bolster the treatment of these conditions.

Delivering Lifesaving Medications to Children with Cancer

Direct Relief is the principal logistics provider for Global HOPE, a collaborative initiative to improve the survival rates of children with cancer and blood disorders in Sub-Saharan Africa to bring them in line with those of wealthy countries. Currently, only 10 to 20 percent of these children survive the disease.

Since 2019, Global HOPE has treated 13,000 children and trained more than 5,600 healthcare professionals in cancer care protocols.

Expanding Access to Cancer Care for Children in Mexico

In Mexico, specialized pediatric cancer care is available only in large cities. For low-income families who live in remote rural areas, the cost of transportation puts cancer care out of reach. Direct Relief and Casa de la Amistad, or CDLA, ensure that hundreds of children from the country’s most resource-poor areas have access to cancer treatment in urban centers. In 2023, Direct Relief and CDLA facilitated cancer treatment of 650 children.

Improving Care for Mothers and Babies

Complications arising from pregnancy are significant causes of death and disability among mothers and babies in low-resource communities. Access to a trained, equipped midwife is one of the most effective ways to ensure healthy pregnancies and safe births.

This year, Direct Relief extended the range of resources available to midwives and health workers to provide care for mothers and babies in medically vulnerable communities. The organization began distribution of its newly-developed Perinatal Health Kit, designed to treat the most common causes of death and disability during and after pregnancy. In 2023, Direct Relief’s Perinatal Health Kits were delivered to maternal healthcare facilities in Bangladesh, Malawi, and Somaliland to support care for 3,750 mothers and babies.

Up to 25% of pregnant women and newborns at partner facilities are estimated to experience the conditions addressed by the Perinatal Health Kit. The amount of supplies provided in 2023 sufficiently equipped midwives and health workers to address all identified cases.

Direct Relief has prepared a 100-pallet shipment of humanitarian medical aid to depart its California distribution center next week, reaching Gaza via Jordan and Egypt.

This outbreak of war following the October 7 attack by Hamas caused a spike in humanitarian health needs and near complete shutdown of humanitarian health assistance to Gaza that Direct Relief has furnished for over a decade – all of which has flowed through Israel in the previously approved channel of assistance that has been overseen and approved by Israeli authorities.

The pending delivery containing 14 tons of requested basic health commodities valued $3.6 million will be consigned to Anera and is the result of weeks of ongoing consultation and coordination with various national governments, international agencies, and on-the-ground organizations, underscoring the commitment of Direct Relief to provide timely and critical support to people in need. These efforts are made possible by Direct Relief’s supporters, which include a recent $1 million investment from the Walmart Foundation.

Anera, a key regional partner of Direct Relief, is a US-based nonprofit with a longstanding, robust presence and record of providing humanitarian assistance in Gaza, the West Bank, Jordan, and Lebanon.

Direct Relief also is assembling additional follow-up support for individuals with diabetes and other chronic conditions who have been unable to obtain needed medications.

Subsequent shipments will include these specialized supplies and will be conducted in accordance with U.S. sanctions laws and with necessary approvals from Israeli and Egyptian authorities.

This initiative follows a $100,000 emergency operating grant issued last month by Direct Relief to Anera to support the organization’s ongoing humanitarian work in Gaza and is part of Direct Relief’s decade-long commitment that has exceeded $100 million in medical essentials to address health needs among residents of the Palestinian territories.

These efforts follow Direct Relief’s recent provision of over $1 million in humanitarian aid to Israel in response to the deadly attacks by Hamas on October 7 and continue its apolitical mission to offer lifesaving support to communities affected by conflict and crisis, regardless of politics or religion.

The shipments contained 15.1 million defined daily doses of medication and supplies, including prenatal vitamins, protective equipment, rare disease therapies, cancer treatments, and chronic disease medications.

Medical Support Continues for Hurricane Otis

Direct Relief staff were in Acapulco last week, where they delivered medical aid to health facilities in the area and groups providing mobile medical care in rural areas.

Hurricane Otis’ impacts continue to interrupt daily life in Acapulco, Mexico. The Category 5 storm caused catastrophic damage when it made landfall in October. With medical care still limited in many areas due to damaged infrastructure, Direct Relief has been supporting medical campaigns bringing care to people where they live. Direct Relief supported the Mexican government’s medical outreach in Guerrero with 30 field medic packs containing medical essentials to provide first aid and basic medical care outside of clinic walls.

Direct Relief has also continued supporting Medical Impact, an NGO conducting mobile clinics throughout Guerrero. Direct Relief has supported the group with emergency operating funds, medicines, and supplies for patient care.

Syrian Hospital Bolsters Care for Neonatal Unit

The smallest patients at Dr. Mohammad Wassim Maaz Hospital in Aleppo, Syria, recently received more support with equipment for the hospital’s NICU. Recently, Direct Relief-donated incubators arrived and are being used to care for newborns.

The hospital run by the Independent Doctors Association, an NGO which provides medical services in northwestern Syria. Direct Relief has provided the group $12.3 million worth of medical aid since 2008.

A video of the incubators being used can be found here.

OPERATIONAL SNAPSHOT

WORLDWIDE

This week, Direct Relief shipped 14.5 million defined daily doses of medication outside the U.S.

Countries that received medical aid over the past week included:

UNITED STATES

Direct Relief delivered 196 shipments containing more than six tons of medications over the past week to organizations, including the following:

YEAR-TO-DATE (GLOBAL)

Since January 1, 2023, Direct Relief has delivered 19,500 shipments to 2,423 healthcare providers in 55 U.S. states and territories and 87 countries.

These shipments contained 507.2 million defined daily doses of medication valued at $1.9 billion (wholesale), totaling 5.9 million lbs.

in the news

Direct Relief Awarded Top 100% Rating by Charity Navigator for Nonprofit Impact, Efficiency, and Transparency in 2023 – PRNewswire

Local non-profit Direct Relief receives perfect score from national charity evaluator – KEYT

Direct Relief’s Medical Donations for U.S. Healthcare Safety Net Exceed $2 Billion – CSR Wire